The concept of "patients-centered" has presented higher requirements doctor-patient communication and reconstructing doctor-patient relationship in public primary health care institutions.

To analyze the impact of "patients-centered" doctor-patient communication on the quality of primary care services, and provide scientific evidence to promote reforms in public primary health care institutions.

All public community health centers providing primary care services in the main urban area of a city in Inner Mongolia Autonomous Region were selected as the study sites to conduct a field survey in 2021 using the standardized patient method, which included 118 items of doctor-patient communication data involving 26 medical institutions, 59 doctors, and 12 standardized patients. Common cold, asthma, and unstable angina were selected as the types of diseases to be portrayed by the standardized patients in this study. A combination of multiple regression model and Probit model was used to evaluate the impact of "patients-centered" doctor-patient communication on the quality of primary care services.

Results obtained from the 118 items of doctor-patient communication data revealed that the median adherence rate for recommended consultation items was 17.6% (14.6%), and the median adherence rate for recommended examination items was 25.0% (40.0%), among them, 75 cases (63.6%) were correctly diagnosed, and 59 cases (50.0%) were correctly treated. The median total cost was 84.84 yuan (130.44 yuan), and the median drug cost was 37.62 yuan (47.38 yuan), among them, 66 (55.9%) involved unnecessary drugs, and 71 (60.2%) included unnecessary examinations. The median visit duration was 13.625 (10.850) min. The average score for "patients-centered" doctor-patient communication was (26.712±10.658), with the first dimension scoring (12.915±5.355) points, the second dimension scoring (7.492±2.867) points, and the third dimension scoring (6.305±3.465) points. The results of multiple linear regression model and Probit model indicated that for every one-point increase in the total score of patient-centered doctor-patient communication, the adherence rates for both recommended consultation items and recommended examinations items increased by 0.001 percentage points, the correct diagnosis rate increased by an average of 4.6 percentage points, the correct treatment rate increased by 4.2 percentage points, the total cost increased by 1.993 yuan, the drug cost increased by 0.517 yuan, the proportion of unnecessary drugs decreased by 3.4 percentage points, the proportion of unnecessary examinations increased by 0.2 percentage points, and the visit duration decreased by 0.291 minutes.

"Patients-centered" doctor-patient communication enhances the effectiveness and safety of medical services, while it also increases medical costs. It is necessary to promote "patients-centered" doctor-patient communication from the aspects of resource endowment, salary incentives, doctor-patient relationships, and collaborative services, thereby improving the quality of primary care services.

Currently, scholars in China are exploring chronic disease management models based on treatment-prevention integration, however, the quantitative evaluation researches are scarce and in the initial stage, lacking in relevance and timeliness.

To construct the on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions and provide a reference for the quality improvement of integration of medical and preventive services.

The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was initially constructed by literature review, policy induction and expert interview. From June to August 2022, two rounds of expert consultation with 17 experts were conducted using the Delphi method, the index system was determined according to the results of expert consultation, and the weight of each index was calculated by using the analytic hierarchy process.

The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was initially constructed consisting of 5 primary indexes, 12 secondary indexes and 37 tertiary indexes. The effective questionnaire recovery rate of the two rounds of expert consultation was 100.0% with the expert authority coefficient of 0.81; the Kendall coordination coefficients of the importance of the three levels of indexes were 0.239 (χ²=8.76, P<0.05) and 0.275 (χ²=4.15, P<0.05) , the Kendall coordination coefficients of the feasibility of the three levels of indexes were 0.234 (χ²=19.63, P<0.05) and 0.248 (χ²=12.43, P<0.05) . The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was finally constructed consisting of 5 primary indexes, 12 secondary indexes and 40 tertiary indexes, the weight of the five primary indicators was 0.200 0.

The evaluation index system has a certain practical guidance for the improvement of the capacity of integration of medical and preventive services for chronic diseases in urban and rural community health service institutions. However, the evaluation index system should also be dynamically adjusted according to the specific situation to effectively reflect the quality of integration of medical and preventive services for chronic diseases in primary health care institutions.

Menopausal hormone therapy (MHT) can effectively relieve menopausal symptoms, but its treatment options are diverse, and it is essential to make treatment decisions meeting women's needs. However, the current investigation on the quality of shared decision making between doctors and patients (SDM) in menopausal hormone therapy needs to be supplemented.

To analyze the quality of SDM in MHT among menopausal syndrome patients and explore its influencing factors, so as to provide a theoretical basis for achieving quality clinical care for menopausal population.

A total of 101 patients with menopausal syndrome from Center for Gynecological Endocrinology and Reproduction in Peking Union Medical College Hospital from October 2022 to January 2023 were selected as study subjects. The study was conducted using the questionnaire method, which consisted of general demographic information, treatment-related information and SDM quality survey. The Chinese version of 9-items shared decision making questionnaire (SDM-Q-9) was used to assess the SDM quality of patients. Multiple linear regression analysis was used to explore the influencing factors of SDM quality in MHT among patients with menopausal syndrome. Multiple linear regression analysis was used to explore the influencing factors of the quality of SDM in MHT among patients with menopausal syndrome.

The average score of SDM quality was 89.75. Patients with children, considered MHT to be very effective, with symptoms of hot flushes and sweating, insomnia and mood fluctuations, advised by doctors to receive MHT had better degree of participation in SDM (P<0.05). Multiple linear regression analysis showed that patients with children (β=0.26, P=0.005), hot flushes and sweating (β=0.19, P=0.044), insomnia (β=0.23, P=0.017) and recommendation by doctors (β=0.21, P=0.025) are influencing factors of SDM quality in MHT of patients with menopausal syndrome, which could explain 23.7% of the variation in SDM quality.

SDM quality is relatively good in MHT among menopausal syndrome patients. Patients with children, hot flashes and sweating, insomnia, and recommendation for use by doctors are influencing factors of SDM quality in MHT among menopausal syndrome patients. Doctors should take the initiative to include patients in SDM, so that patients can realize that they are the principal leader of their health and make SDM consistent with their needs and values in conjunction with doctors.

Prevention of disease in Traditionnal Chinese Medicine (TCM) is a distinguishing advantage of TCM health management services, however, the holistic health state of the patients remains to be elucidated and evaluated.

To evaluate the health-related quality of life (HRQoL) and its influencing factors in patients with prevention of disease in TCM.

From May to June 2022, a stratified cluster sampling method was used to randomly select a district-level TCM hospital from each of the four administrative regions of Guangzhou (Liwan District, Tianhe District, Baiyun District, Huadu District) as the research site. The EQ-5D-5L scale was used to investigate the patients with prevention of disease in TCM by questionnaire in primary care, and the health utility value was calculated according to the Chinese EQ-5D utility score system. The influencing factors of health utility value and EQ-VAS score were analyzed by using optimal scale regression analysis.

A total of 660 questionnaires were completed in this survey, including 630 valid questionnaires, with a effective recovery rate of 95.45%. Among the 630 investigated patients with prevention of disease in TCM, 185 patients (29.4%) visited for daily health care, 242 patients (38.4%) visited at the initial stage of disease for discomfort, 218 patients (34.6%) visited for avoiding exacerbation of current illness, 67 patients (10.6%) visited for post-illness rehabilitation physiotherapy. The top three conditions for prevention of disease in TCM were insomnia disorder, epigastric pain and arthralgia. The EQ-5D-5L health utility value for the investigated patients was 0.942 (0.893, 1.000), and the EQ-VAS score was 80 (70, 90). All five dimensions based on the ranking of difficulties frequency were pain/discomfort (50.2%), anxiety/depression (46.9%), daily activities (14.4%), mobility (9.9%) and self-care (6.0%). The influencing factors of health utility value based on the ranking of importance were the main causes of most recent prevention of disease in TCM (0.366), age (0.281), comorbidities of TCM conditions (0.145), occupation (0.111) and education level (0.098). The influencing factors of EQ-VAS score based on the ranking of importance were marital status (0.378), understanding of prevention of disease in TCM (0.353), age (0.176) and monthly income (0.092) .

The HRQoL of patients with prevention of disease in TCM in primary care in Guangzhou is at a medium level. The health utility values were relatively low in patients suffered from TCM conditions such as lung cancer, stroke, chronic obstructive pulmonary disease, osteoporosis and breast cancer, aged 60 and above, comorbid with 2 or more TCM conditions, with manual labour and lower education level. The self-rated health status was relatively poor in patients absence from marriage, unaware of prevention of disease in TCM, aged 60 and above, with higher monthly income. HRQoL should be applied reasonably as an important outcome indicator. Attention should be paid to the population with poor HRQoL among patients with prevention of disease in TCM, the promotion and dissemination of the concept and connotation of prevention of disease in TCM should be strengthened.

China is facing an increasing number of chronic disease patients. Health-related quality of life (HRQoL) is an important indicator assessing the effect of prevention and treatment measures for chronic diseases, so it is important to select an appropriate HRQoL measurement tool for these patients.

To compare the validity, consistency and correlation of the Chinese Medicinal Quality of Life scale (CQ-11D) , Short-form 6-dimension version 1 (SF-6Dv1) , and the 3-level version of EQ-5D (EQ-5D-3L) in terms of utility values measuring HRQoL in chronic disease patients, and to identify a scale that is most applicable to Chinese chronic disease patients.

From February 2021 to April 2021, this study recruited the initial sample of Chinese people using quota sampling with quotas based on sex and age from a total of 28 representative provinces, autonomous regions or municipalities selected from seven geographical regions (north China, northeast China, east China, central China, southwest China, northwest China, and south China, with 2 to 6 selected from each of the regions) . A face-to-face survey was used to collect the sample people's basic demographic information and the situation of chronic diseases, and self-reported HRQoL measured using the CQ-11D, SF-6Dv1 and EQ-5D-3L, respectively, then according to the survey results, those with chronic diseases were selected, and the utility values of the three scales in them were analyzed. Bland-Altman chart and intraclass correlation coefficient (ICC) were used to analyze the consistency and correlation of the three scales. Kruskal-Wallis H test was used for univariate analysis to determine whether or not there is a statistically significant difference between the utility values of the scales across age or sex groups.

A total of 692 chronic disease patients were finally included. The mean (standard deviation) of utility scores of CQ-11D, SF-6Dv1 and EQ-5D-3L scales were (0.855±0.168) , (0.793±0.132) and (0.876±0.136) , respectively. The top three prevalent chronic diseases were hypertension (n=275) , arthritis (n=128) and hyperlipidemia (n=124) . Histogram showed that EQ-5D-3L had obvious ceiling effect, and CQ-11D was more widely distributed. The Bland-Altman chart showed that the consistency between the three scales was relatively good, and the points within the 95% limits of agreement (LOA) were all about 95%. The strength of correlation between CQ-11D and visual analogue score (VAS) was the highest (P<0.001) . The ICC among the three scales ranged from 0.528 to 0.625, showing a moderate level of correlation (P<0.001) . Both Bland-Altman chart and ICC analysis showed that SF-6Dv1 and EQ-5D-3L had the best consistency. The results of analysis for the three chronic diseases in subgroups were similar to those in the total sample. Univariate analysis showed that male patients with hypertension or hyperlipidemia had higher utility scores of three scales than their female counterparts (P<0.05) . And the utility scores of three scales were the lowest in 60-year-olds and above among patients with hyperlipidemia.

The ceiling effect of EQ-5D-3L scale is obvious in patients with chronic diseases. CQ-11D demonstrated a wide range of distribution of utility values in measuring the three chronic diseases, which may be more suitable for measuring HRQoL in Chinese chronic disease population, as no ceiling effect was observed and its correlation with VAS was the strongest.

Adequate gestational weight gain (GWG) is critical for maternal and child health. The Institute of Medicine (IOM) standard has long been adopted in clinical practice to guide GWG in China. Since October 2022, China has officially promulgated and adopted the Standard of Recommendation for Weight Gain during Pregnancy Period (WS/T 801-2022) (herein after referred to as SRWGPP) to guide GWG.

To compare the distribution of GWG recommended by the SRWGPP and IOM used for Chinese singleton pregnant women and associated adverse pregnancy outcomes, providing clinical evidence for further application of the SRWGPP.

The data of this study were from a prospective cohort study involving singleton pregnant women who gave birth in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from May 2020 to September 2021 and participated in the Beijing Birth Cohort Study (registration number: ChiCTR220058395) . Baseline information was collected from the participants, and the incidence of pregnancy complications and outcomes was obtained from the clinical health record system. We compared the distribution of GWG of the participants based on the criteria by the SRWGPP and the IOM guidelines. Then we divided the participants into five groups: insufficient weight gain (IOM+IW) , insufficient weight gain+appropriate weight gain (IOM+IW+AW) , appropriate weight gain (IOM+AW) , appropriate weight gain+ excessive weight gain (IOM+AW+EW) , and excessive weight gain (IOM+EW) . The risk of adverse pregnancy outcomes〔large for gestational age (LGA) , small for gestational age (SGA) , macrosomia, low birth weight, and preterm birth〕 was analyzed after adjusting for confounding factors.

A total of 11 839 singleton pregnant women were included. The proportions of women with insufficient, appropriate, and excessive GWG were 36.7% (4 339/11 839) , 38.9% (4 601/11 839) , and 24.5% (2 899/11 839) , respectively, according to the IOM standard, and were 16.2% (1 913/11 839) , 45.0% (5 332/11 839) , and 38.8% (4 594/11 839) , respectively, according to the SRWGPP. The proportions of pregnant women in groups of IOM+IW, IOM+IW+AW, IOM+AW, IOM+AW+EW and IOM+EW were 16.2% (1 913/11 839) , 20.5% (2 426/11 839) , 24.6% (2 907/11 839) , 14.3% (1 694/11 839) and 24.5% (2 899/11 839) , respectively. The results from multivariate Logistic regression analysis showed that the risk of overall adverse pregnancy outcomes in IOM+AW+EW group was higher than that in IOM+AW group〔aOR=1.23, 95%CI (1.07, 1.41) , P<0.05〕. There was no difference in the risk of overall adverse pregnancy outcomes between IOM+IW+AW group and IOM+AW group〔aOR=1.02, 95%CI (0.89, 1.16) , P<0.05〕. The risk of LGA, macrosomia, cesarean section, or the overall adverse pregnancy outcomes was higher in IOM+EW group than that in IOM+AW group either in the first or second trimesters (P<0.05) .

The adoption of the SRWGPP will allow more pregnant women to meet the appropriate range for GWG, and their pregnancy outcomes will be better than those using the IOM standard. Therefore, the SRWGPP is more applicable to Chinese pregnant women for pregnancy weight management. Especially, it is critical to avoid excessive GWG in the first and second trimesters.

Exploring the factors affecting health service utilization is of great significance for optimizing the allocation of health services. Health-related quality of life (HRQoL) focuses on individuals' subjective self-assessment of their current health status, and may affect their health-seeking behaviors, but there are few studies on the impact of HRQoL on health service utilization of rural residents in China.

To explore the relationship between HRQoL and health service utilization of rural residents in Ningxia Hui Autonomous Region, and to provide a reference for the development of relevant policies/plans, and for the optimization health services in rural areas.

Data were collected from the Health Survey of Rural Residents Families 2019 conducted in four sample counties of Ningxia (Haiyuan, Pengyang, Xiji, Yanchi) from July to August 2019, involving 9 310 cases (≥15 years) with complete key information (gender, age, HRQoL-related indicators, health service utilization indicators). Detailed data of the residents were extracted, including socio-economic and demographic characteristics, health services accessibility, prevalence of chronic diseases, HRQoL measured using European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) and utilization of health services. The effects of health state utility values and visual analog scale (VAS) score on outpatient and inpatient health service utilization were analyzed by binary Logistic regression.

The utilization rates of outpatient and inpatient health services of rural residents in Ningxia were 10.85% (1 010/9 310) and 18.86% (1 756/9 310), respectively. The mean health state utility values and mean VAS score of them were (0.965±0.090) and (69.97±17.84), respectively. Difference testing showed that residents with impaired self-care (in the EQ-5D-3L descriptive system) had higher rates of using outpatient health services〔OR (95%CI) =3.197 (2.633, 3.883), P<0.001〕and inpatient health services〔OR (95%CI) =4.802 (4.059, 5.681), P<0.001〕compared with those with impaired mobility, usual activities, or higher level of pain/discomfort or anxiety/depression. Binary Logistic regression analysis showed that after adjusting for various confounding factors, health state utility values and VAS score were associated with the use of outpatient and inpatient health services (P<0.05). Moreover, the prevalence of chronic diseases also significantly affect the utilization of outpatient and inpatient health services (P<0.05) .

HRQoL and the prevalence of chronic diseases were leading factors affecting the utilization of outpatient and inpatient services in Ningxia rural residents. As an independent predictive factor of residents' health service utilization, HRQoL can be used to assist in the evaluation and monitoring of health service quality and effect, and provide guidance for rational allocation of health resources.

Frailty can increase the risk of negative health-related outcomes in older adults. Protein supplementation may be an effective way to improve frailty, but there is disagreement about its effects on frailty.

To systematically evaluate the effects of protein supplementation on muscle mass, strength, and physical function in frail/pre-frail older adults.

Electronic databases of CNKI, Wanfang Data, CQVIP, PubMed, Embase, Web of Science, Cochrane Library, CINAHL and Medline were retrieved for randomized controlled trials (RCTs) of the effects of protein supplementation on muscle mass, strength and physical function in frail/pre-frail older adults published from inception to June 2022. After literature screening, the quality of eligible RCTs was evaluated, and from which relevant data were extracted. RevMan 5.4 was performed to explore the effects of protein supplementation on muscle mass, muscle strength and physical function in frail/pre-frail older adults. And for the outcome indicator of muscle strength (grip strength) , due to large amount of reported literature, this study will be based on the amount of protein supplementation (<30 g/d subgroup and≥30 g/d subgroup) , frailty status (pre-frailty subgroup, frailty subgroup, frailty and pre-frailty subgroup) , frailty assessment tool 〔frailty phenotype assessment tool (FP) subgroup and non-FP subgroup〕, population (Asian subgroup and European subgroup) , and mean age (70-<75 years subgroup, 75-<80 years subgroup, and 80-<85 years subgroup) for subgroup analysis to further explore the effect of protein supplementation on grip strength in different subgroups.

A total of 12 RCTs were included (2 literatures for pre-frailty, 3 literatures for frailty, 7 literatures for frailty and pre-frailty) , with a total of 833 older adults (422 in the protein supplementation group and 411 in the control group) . Meta-analysis results showed that protein supplementation improved gait speed in frail/pre-frail older adults〔MD=0.03, 95%CI (0, 0.06) , P=0.05〕, but in improving muscle mass (appendicular lean mass) , muscle strength (grip strength) , other physical functions (assessment results of balance test, the timed up and go test, Short Physical Performance Battery) and frailty scores, the differences were not statistically significant (P>0.05) . The results of subgroup analysis showed that the effect of protein supplementation on the grip strength of the Asian population subgroup was significantly different from that of the European population subgroup in between-group comparisons (χ²=5.76, P=0.02) .

Protein supplementation may improve gait speed in frail/pre-frail older adults, but it does not show a significant advantage in improving their muscle mass, muscle strength and other physical functions. It is recommended to further investigate the effects of longer durations of supplementation, different types of protein supplemented, different amounts of supplementation and different regional populations on older adults with different frailty states, in order to find the best pattern of protein supplementation and provide a more sufficient evidence-based basis for frailty management.

Non-alcoholic fatty liver disease (NAFLD) is a common disease of the digestive system. With the improvements of living standards and breakthroughs in viral hepatitis research, NAFLD has replaced viral hepatitis as the most common chronic liver disease. Guidance documents can provide clinical staff with standard and reliable diagnosis and treatment approaches. The screening and development of high-quality guidance documents is of great importance to standardise the clinical practice of NAFLD.

To analyze the methodological quality and reporting quality of guidance documents for NAFLD, summarize and compare the recommendations, so as to provide a reference for the development and report of future guidelines for NAFLD.

PubMed, CNKI, CBM, Wanfang Data Knowledge Service Platform, VIP Database were searched for clinical guidelines and consensuses on NAFLD supplemented by WHO, GIN, NICE, SIGN and Medlive from 2012-01-01 to 2022-01-01. Two researchers in the field of liver disease screened the literature, extracted the data and independently evaluated the methodological quality and reporting quality of the included guideline documents using AGREE Ⅱ and RIGHT, respectively. The recommendations of the higher quality guideline documents were collated and compared by the two researchers.

A total of 19 publications were enrolled, including 12 guidelines and 7 consensuses; 6 in Chinese and 13 in English; 10 of which were developed using an evidence-based approach. The average scores for each domain of AGREE Ⅱ were 42.84% for scope and purpose, 31.43% for participants, 31.25% for rigour, 60.67% for clarity, 32.68% for application and 37.50% for independence. The average scores of RIGHT in each area were 59.65% for basic information, 66.12% for background, 42.11% for evidence, 39.85% for recommendations, 17.11% for review and quality assurance, 18.42% for funding and conflict of interest statement and management, 47.37% for other aspects. The average scores in AGREEⅡ and reporting qualities in RIGHT of evidence-based guidance documents were both higher than non-evidence-based guidance documents. The average scores in AGREEⅡ and reporting qualities in RIGHT of foreign guidance documents were higher than domestic guidance documents. The main recommendations relate to screening and diagnosis, assessment, management (non-pharmacologic and pharmacologic treatment) and surgical treatment.

The methodological quality and reporting quality of the published guidance documents for NAFLD still need to be improved, and there are still gaps between domestic guidance documents and international guidance documents. The development of TCM guidance documents should follow an evidence-based approach. Further reference should be made to international standards such as AGREE Ⅱ and RIGHT in the development and reporting of guidelines. Clinical screening awareness for high-risk population of NAFLD and a comprehensive system for early non-invasive diagnosis and assessment should be established. Multidimensional treatment plans for lifestyle, liver function and metabolic disorders should be provided for patients with NAFLD.

At present, the contracting rate of family doctors in China is high, but there are problems such as low service quality and low service utilization rate.

To comprehensively investigate the current situation of contracting, performance and renewal of family doctor services in Meizhou and Heyuan cities of Guangdong Province, and explore the impact of appointment consultation service on the quality of contract services.

From July to August 2021, 11 districts and counties in Meizhou and Heyuan cities were selected using a multi-stage sampling method, the list of rural health centers that can be investigated was provided by the health bureau of each district (county). The questionnaire was administered through the "questionnaire star" platform to the head of the rural health centers or the directors of public health. The questionnaire was prepared by the Guangdong Internet + Family Doctor Contract Guidance Center, which was called "Guangdong Family Doctor Contract Service Current Situation Questionnaire", including the basic information of the invesgated rural health centers, the current situation and progress of family doctor contract service. Based on the structure-process-outcome (SPO) model, the dependent variables were set as outcome quality indicators (effective contract rate of general population/focused population, number of institutions with difficulty in compliance and low renewal rate) to compare the current situation of family doctor contract service in rural health centers with different appointment consultation service provision capacity. The Logistic regression was used to analyze the impact of appointment consultation service on the outcome quality of contract service.

The median family doctor contract rate of 100 rural health centers for focused population and general population was 69.0% (60.0%, 85.0%) and 31.8% (29.1%, 54.5%), respectively; the number of institutions reaching family doctor contract service coverage target for focused population/general population of 2025 was 42 (42.0%) and 30 (30.0%), respectively. A total of 78 (78.0%) of these 100 rural health centers faced difficulties in compliance implementation, including 38 (90.5%) rural health centers did not provide appointment consultation service; 50 (50.0%) rural health centers had problems with low renewal rates, including 18 (42.9%) of which did not provide appointment consultation service and faced difficulties in compliance implementation. Logistic regression analysis showed that among the health centers reaching the target, there was no effect the providing of appointment consultation service on the contracting rate of family doctors in the focused and general population (P>0.05) ; among the 100 investigeted health centers, the providing of appointment consultation service had a significant effect on the compliance difficulties of the contracted institutions〔OR (95%CI) =0.28 (0.08, 0.98), P<0.05〕; and the providing of appointment consultation service had no effect on the low renewal rate of contracted residents (P>0.05) .

The performance of family doctor contract service in Guangdong Province is closely related to the providing of appointment consultation service by the health cenyers, and it is recommended to enrich the form and content of appointment service in the process of subsequent service, enhance residents' trust and motivation to use the service actively through the Internet + platform "improve efficiency and quality", while injecting motivation for service provision and utilization from both doctors and patients in order to provide continuous and effective integrated medical and health services as well as health management.

The clinical practice guidelines in general practice can improve healthcare quality in primary health care, however, no study has yet systematically investigated the current status and quality of the guidelines in China.

To investigate the current status and influencing factors of quality of the guidelines in China.

We searched China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese biomedical literature database, and CQVIP website, and included the published guidelines in China. We analyzed the basic characteristics and used RIGHT to evaluate the reporting quality and AGREE-China for methodological quality.

A total of 150 guidelines were included, mainly published from 2019 to 2021. Most of the guidelines〔108 (72.0%) 〕focused on the diagnosis and treatment of diseases. The top three specialties were cardiovascular disease〔40 (26.7%) 〕, gastroenterology〔31 (20.7%) 〕, and clinical pharmacy〔27 (18.0%) 〕. The main development institutions were the Chinese Medical Association and its branches〔123 (82.0%) 〕, the editorial committee of the Chinese Journal of General Practitioners〔119 (79.3%) 〕, and the Chinese Medical Journals Publishing House〔116 (77.3%) 〕. In terms of reporting quality, the average reporting rate of RIGHT was 23.6% (11.4%-42.9%) ; the reporting rate of basic information (59.8%) was higher, and that of evidence (0.3%) was the lowest. As for methodological quality, the average AGREE-China score was 23.4 (12.0-40.0) ; the reporting rates of conflicts of interest (63.0%) and availability/feasibility (53.0%) were higher, and that of economics (7.0%) was the lowest.

The number of Chinese clinical practice guidelines in general practice has increased rapidly in the past five years, which has played an important role in promoting the quality of primary health care. In the future, it is necessary to further develop the guidelines in different specialties and diseases and accelerate the methodology of development and reporting of the guidelines.

Cardiometabolic index (CMI) is a simple index to measure blood lipid, which is closely related to diabetes and stroke. Metabolically obese normal weight (MONW) individuals have higher risks of morbidity and mortality of diabetes and cardiovascular and cerebrovascular diseases. Correctly identifying individuals with MONW phenotype is essential for the prevention and control of metabolism-related diseases. However, there are few studies on the predictive value of CMI for MONW phenotype.

To investigate the association between CMI and MONW phenotype, and to evaluate the predictive value of CMI for MONW phenotype.

The multistage stratified cluster sampling method was used to select permanent residents aged ≥18 years as subjects from Nanjing. The investigation time was from January 1, 2017 to June 30, 2018. The basic data of subjects were collected and multivariate robust Poisson regression model was used to evaluate the RR value with 95%CI of CMI for MONW phenotype. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of CMI, waist-to-height ratio (WHtR) , triglyceride/ high-density lipoprotein cholesterol (TG/HDL-C) ratio, waist circumference (WC) and body mass index (BMI) for MONW phenotype. DeLong test was used to compare the area under the ROC curve (AUC) of the above-mentioned five indicators, and to further explore the value of CMI in predicting MONW phenotype in different gender and age groups.

A total of 30 408 people were included, including 13 213 males and 17 195 females, 23 691 cases of MHNW and 6 717 cases of MONW. There was statistically significant difference in age, education, occupation, current smoking, alcohol consumption, physical activity, duration of static behavior, high red meat intake, disease history, medication history, height, waist circumference (WC) , body mass index (BMI) , total cholesterol (TC) , triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C) , systolic blood pressure (SBP) , diastolic blood pressure (DBP) , fasting blood glucose (FPG) , TG/HDL-C, waist-height ratio (WHtR) and CMI (P<0.05) . There was statistically significant difference in age, education, occupation, current smoking, alcohol consumption, duration of static behavior, high red meat intake, history of disease, medication, height, WC, BMI, TC, TG, HDL-C, LDL-C, SBP, DBP, FPG, TG/HDL-C, WHtR, and CMI of male MHNW and NONW phenotypes (P<0.05) . There was statistically significant difference in age, education, occupation, current smoking, alcohol consumption, physical activity, duration of static behavior, history of disease, medication, height, WC, BMI, TC, TG, HDL-C, LDL-C, SBP, DBP, FPG, TG/HDL-C, WHtR, and CMI of the female MHNW and NOWN phenotype subjects (P<0.05) . The number of Q1 to Q4 groups was 7 739, 7 940, 7 904, 6 825, and the CMI range was ≤0.253, 0.254 to 0.382, 0.383 to 0.539, and ≥0.540, respectively. Male subjects in Q1 to Q4 were 2 697, 3 410, 3 661, 3 445, and the CMI range was ≤0.281, 0.282 to 0.407, 0.408 to 0.569, and ≥0.570, respectively. 5 042, 4 530, 4 243 and 3 380 female subjects in Q1 to Q4 group were studied, and the CMI ranges were ≤0.235, 0.236-0.361, 0.362-0.516 and ≥0.517, respectively. After adjusting for confounding factors, the CMI quartile grouping was the factor affecting metabolic phenotype in all subjects, male subjects, and female subjects (P<0.05) . Multivariate robust Poisson regression model analysis showed that the risk of MONW phenotype in the general population, male and female increased by 68%, 55% and 81% with each additional SD of CMI. In male subjects, CMI predicted MONW phenotype better than WHtR (Z=18.97, P<0.001) , TG/HDL-C (Z=12.53, P<0.001) , WC (Z=23.85, P<0.001) and BMI (Z=24.13, P<0.001) . The predictive power of CMI for MONW phenotype in female subjects was higher than that of WHtR (Z=27.38, P<0.001) , TG/HDL-C (Z=15.27, P<0.001) , WC (Z=30.83, P<0.001) and BMI (Z=30.84, P<0.001) . The AUC value of CMI predicted MONW phenotype in female subjects was higher than that in male subjects (Z=-6.10, P<0.001) , and the difference was statistically significant. In male subjects, the AUC predicted by CMI from 18 to 34 years old was 0.835〔95%CI (0.818, 0.852) 〕, higher than that of 35 to 44 years old (Z=1.55, P=0.04) , 45 to 54 years old (Z=6.92, P<0.001) , 55 to 64 years old (Z=4.95, P<0.001) , ≥65 years old (Z=7.92, P<0.001) ; In female subjects, the AUC predicted by CMI from 18 to 34 years old was 0.832〔95%CI (0.817, 0.847) 〕, which was higher than that of 35 to 44 years old (Z=1.95, P=0.03) , 45 to 54 years old (Z=2.56, P=0.02) , 55 to 64 years old (Z=3.79, P<0.001) , ≥65 years old (Z=5.71, P<0.001) .

CMI was positively associated with the risk of the MONW phenotype, which has strong predictive power and can be used as an effective tool to identify MONW phenotype in the general population, especially in 18-34 years-old people.

Oxidative stress and energy metabolism are important factors that affect sperm quality in male individuals. However, the majority of available studies are based on animal models, and evidence from human studies is still inadequate. Besides, most previous studies have paid more attention to the effects of oxidative stress and energy metabolism on sperm concentration and motility, with a little focus on their impact on sperm motility velocity and trajectory and other specific objective indicators evaluating the state of male infertility.

To investigate the effects of biological indicators related to oxidative stress and energy metabolism on sperm concentration, motility, movement velocity and trajectory in male adults, thus to provide epidemiological evidence for precise intervention of male reproductive health problems.

One hundred and nine volunteers were recruited as subjects from the Center of Reproductive Medicine in Xijing Hospital, Air Force Medical University from June to December 2021. Their semen samples were collected. The computer-assisted sperm analysis system was applied to detect sperm concentration parameters (sperm concentration, linear motion sperm concentration), sperm motility〔total sperm motility, progressive motility (PR), non-progressive motility (NP) 〕, sperm motility velocity parameters〔curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP) 〕 and sperm motility trajectory parameters 〔mean amplitude of lateral head displacement (ALH), mean beat-cross frequency (BCF), mean angular displacement (MAD), linearity coefficient (LIN), wobble coefficient (WOB), straightness coefficient (STR) 〕. Besides that, the levels of malondialdehyde (MDA) and reduced glutathione (GSH) in semen samples were measured as oxidative stress markers, and the level of sperm adenosine triphosphate (ATP) was measured to assess the level of energy metabolism. General linear model (GLM) was used to evaluate the correlation of MDA and GSH and ATP with sperm quality parameters.

A total of 67 sperm samples were used to examine oxidative stress level, and 42 sperm samples were employed to assess the level of energy metabolism. The analysis using the GLM demonstrated that in terms of oxidative stress level, MDA level was negatively correlated with linear motion sperm concentration, total sperm motility, PR, NP, VCL, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05) ; the level of GSH was positively correlated with linear motion sperm concentration, total sperm motility, PR, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05). In terms of energy metabolism, the level of ATP was positively correlated with linear motion sperm concentration, total sperm motility, PR, NP, VCL, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05) .

Higher level of oxidative stress is associated with lower sperm motility, lower velocity of sperm movements, and the adverse change in sperm trajectory. While higher ATP level is related to higher sperm motility, higher sperm movement velocity, and the favorable change of sperm trajectory.

Degenerative lumbar spinal stenosis (DLSS) is a costly disease that mainly occurs during the old age, which seriously affects the normal life. There are many treatment options for DLSS. The development and clinical application of high-quality clinical practice guidelines are major ways to improve the diagnosis and treatment of DLSS.

To provide a reference for the development and reporting of clinical practice guidelines of DLSS, with guidelines of DLSS evaluated using AGREEⅡ and RIGHT, from the perspectives of methodology and quality.

Databases were searched for clinical practice guidelines, consensuses and specifications about DLSS, including CBM, CNKI, Wanfang Data, VIP, PubMed, Medlive, WHO, the National Institute for Health and Care Excellence, Guidelines International Network, National Guideline Clearinghouse and Scottish Intercollegiate Guideline Network from January 1, 2010 to January 1, 2022. The methodological quality and reporting quality of included studies were evaluated by two raters independently. And the recommendations in the studies were compared under the uniform grading criteria.

Six studies were enrolled, including four guidelines and two consensuses. One guideline is based on TCM, and the other three are evidence-based guidelines. The evaluation results of AGREEⅡ showed that the ratio of the actual total score to the full score of the six included studies was 78.2%, 53.6%, 45.7%, 37.7%, 28.2% and 15.0%, from highest to the lowest. RIGHT evaluation showed that the ratio of the actual total score to the full score of the four guidelines was 72.9%, 72.9%, 62.9% and 34.3%, from highest to the lowest. A total of 46 therapeutic and 11 non-therapeutic recommendations were developed in the six studies.

The methodological quality and reporting specification of the present DLSS guidelines and consensuses require to be further improved. Further reference should be made to international standards such as AGREE Ⅱ and RIGHT in the process of guideline development and reporting. Surgical treatment is the preferred recommendation for patients with moderate or severe DLSS.

Scale assessment for irritable bowel syndrome (IBS) has been widely implemented in clinical practice, how to choose an appropriate assessment tool is very important. In view of this, we used literature research methodology to search patient-reported outcomes and disease-specific health-related quality of life instruments for IBS, summarized their main contents and psychometric properties, then put forward recommendations on the selection of the instruments. A total of 37 commonly used instruments for IBS were retrieved, which have proven to have good reliability, validity and responsiveness, and can be better applied in clinical practice. We suggest medical professionals and researchers choose an assessment instrument for IBS according to the purpose and content of their research.

Chinese aging population degree will transform mild to moderate. During addressing aging issues by proactive national strategies and healthy aging strategies, the sleep health of older peoplecannot be ignored.

To explore the effect of working after retirement on sleep quality in Chinese older people, providing relevant reference data for improving sleep quality in this group of people.

In August 2021, data of working after retirement prevalence and sleep health in subjects aged ≥60 years (n=7 862) were obtained from the 2018 China Family Panel Studies (CFPS) conducted by Peking University with permission. They were divided into working after retirement and non-working after retirement groups by working after retirement prevalence. Normal sleep duration (within 4 to 10 hoursper night) , abnormal sleep duration (≤4 or ≥10 hours per night) , sleeping late (going to bed after 23 o'clock) in accordance with relevant diagnostic criteria used in international studies on sleep health in middle-aged and older people. Self-reported perceptions of sleep quality were classified into optimistic and pessimistic according to subjective evaluation of sleep efficiency and effect. Binary Logistic regression model was used to explore the effect of working after retirement on sleep duration, perception of sleep quality and the time to go to sleep.

Among the subjects, 5 705 (72.56%) had optimistic sleep quality, 6 508 (82.78%) had normal sleep duration, and 7 464 (94.94%) went to sleep earlier than 23: 00, and 4 005 (50.94%) still worked after retirement. After controlling for age, gender, maritalstatus, education level, personality traits and other factors, working after retirement was associated with increased probability of higher optimism with sleep quality〔OR (95%CI) =1.205 (1.069, 1.358) 〕, more normal sleep duration〔OR (95%CI) =1.306 (1.137, 1.499) 〕, and earlier time to go to sleep〔OR (95%CI) =1.596 (1.253, 2.033) 〕.Working after retirement was associated with increased probability of good sleep quality (P<0.05) .

As working after retirement may be contributive to good sleep quality in older people, it should be supported and guaranteed by governmental policies.

The quality of life of patients with nephrotic syndrome requires a lot of focus, and improvements. A relevant scale can be used to measure it, but there is no nephrotic syndrome-specific quality of scale.

To develop a Quality of Life Instruments for Chronic Diseases-Nephrotic Syndrome〔QLICD-NS (V2.0) 〕 combined with QLICD-GM (V2.0), then verify it using the classical test theory.

From 2017 to 2021, an item pool was established according to literature review and the results of a semi-structured questionnaire, then the items were screened in accordance with a pre-test and importance score rated by physicians and patients, after that, the draft of the QLICD-NS (V2.0) was developed. The draft version was tested using onsite interview and questionnaire survey in nephrotic syndrome patients treated in Department of Nephrology, the Affiliated Hospital of Guangdong Medical University from March to November 2021. The first measurement was conducted on the day of admission, the second measurement was conducted with some of the patients, and the third measurement was conducted on the day of discharge. The coefficient of variation, correlation coefficient and Cronbach's α, factor analysis and classical test theory were used to evaluate QLICD-NS (V2.0) .

The QLICD-NS (V2.0) contains 15 items, belonging to three domains of clinical symptoms, adverse drug reactions and psychological effects. The Cronbach's α measuring the split-half reliability was greater than 0.7 for the scale and each of the three domains. With the Chinese version of SF-36 as the calibration standard, the domains of the QLICD-NS (V2.0) were highly correlated with their counterpart domains of the Chinese version of SF-36. The standardized response mean was greater than 0.80 for all domains and items (except for the cognition and social support items), indicating that the responsiveness of the QLICD-NS (V2.0) was good. Scanning the QR code in the text can obtain the detailed evaluation of the scale.

The QLICD-NS (V2.0) compiled by us includes 15 items, and has proven with good reliability, validity and responsiveness.

Periviable neonates have been implicated in a higher incidence of multi-organ injuries and complications due to the extreme prematurity, which is usually associated with poor prognosis. To date, postnatal management of periviable neonates remains one of the most challenging issues, and has been reported by limited studies. By individualized treatment and intensive care, including effective resuscitation, respiratory and circulatory support, active nutritional support and feeding, prevention and treatment of infection, management of endocrine and metabolic problems, management of preterm-related complications, and individualized nursing such as developmentally supportive care and family integrated care, a periviable baby with gestational age of 230/7 weeks and birth weight of 450 g was successfully rescued by Sichuan Academy of Medical Sciences· Sichuan Provincial People's Hospital. We summarized early postnatal management of this periviable baby and reviewing relevant literature, aiming at providing evidence for improving the survival and prognosis of periviable babies with birth weight <500 g.

Enuresis in children is a common pediatric disease that can significantly reduce the quality of life of children and their families. High-quality guidelines on enuresis in children contribute to the standardization of control and improvement of clinical symptoms. So developing relevant high-quality clinical practice guidelines is a critical way to improve the diagnosis and treatment of enuresis in children.

To evaluate the quality of guidelines and expert consensuses on enuresis in children issued since 2010 using the AGREE Ⅱ and RIGHT checklists, aiming at providing a reference for clinical practice and future development of relevant guidelines.

Guidelines and expert consensuses related to enuresis in children published from January 1, 2010 to January 31, 2022 were searched in databases of CNKI, Wanfang Data, VIP, CBM, and PubMed (with searching databases of MedLive, WHO and NICE as a supplement) . The AGREE Ⅱ and RIGHT checklists were used to evaluate the methodological and reporting quality of included studies. According to the AGREEⅡ, the recommended grade of each guideline/consensus was rated as "recommended (A) ", "recommended after update (B) ", and "not recommended (C) ". The intra-class correlation coefficient (ICC) was used for the consistency test.

Altogether, eight guidelines and five consensuses were included, which provide 185 recommendations, including 44 for diagnosis and evaluation, 140 for treatment, and one for follow-up. By the AGREEⅡchecklist, these 13 studies were assessed with average scores of (66.99%±16.73%) , (46.26%±21.56%) , (34.42%±26.73%) , (60.36% ±32.13%) , (39.82%±20.14%) and (45.35%±37.93%) for scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence, respectively. None of the studies were with recommendation grade A, eight were with recommendation grade B, and five were with grade C. The reporting rates of the studies in accordance with seven domains of basic information, background, evidence, recommendations, review and quality assurance, funding and declaration and management of interests and other information were (60.58%±12.19%) , (50.72%±20.18%) , (30.77%±26.88%) , (32.97%±27.53%) , 25.00% (40.63%) , (25.96%±24.00%) and 16.67% (33.33%) , respectively. The guidelines had higher score in terms of the scope and purpose domain of AGREEⅡ than consensuses (P<0.05) . The guidelines and consensuses had no significant differences in assessment results by each of the seven domains of RIGHT (P>0.05) . The ICC for the reliability of each of the domains of the AGREEⅡchecklist in assessment was greater than 0.750, showing a high consistency. The ICC for the reliability of each of the domains of the RIGHT checklist was 0.736, which showed a good consistency.

The overall methodological and reporting quality of the included guidelines and consensuses needs to be improved. The recommended grades of the included literature consist of B and C without A, suggesting that high-quality guidelines should be referred first when making clinical decisions. Currently, there is no guideline for the diagnosis and treatment of enuresis in children in primary care in China, and the quality of existing guideline on Traditional Chinese Medicine management of enuresis in children needs to be improved. It is suggested to develop relevant guidelines according to the AGREE Ⅱ and RIGHT checklists to guide the clinical management of enuresis in children.

Older people are a group susceptible to hypertension, and among whom hypertension prevalence is increasing as population aging aggravates. Early prevention, diagnosis and treatment of hypertension in the elderly are very important, which can be enhanced by an important way, namely developing high-quality clinical practice guidelines.

To perform an analysis of the guidelines regarding the diagnosis and management of hypertension in the elderly, and to assess their methodological quality.

In December 2021, we searched for clinical guidelines for hypertension in the elderly in databases of CNKI, CQVIP, WanFang Data, SinoMed, PubMed, EmBase and Medlive, as well as in the official websites of the National Guideline Clearing house, the Guidelines International Network and the National Institute for Health and Care Excellence from inception to December 2021. Two reviewers independently conducted literature screening and data extraction. Four reviewers independently evaluated the methodological quality of included guidelines using the AGREEⅡ. Recommendations from each guideline were retrieved.

A total of 11 guidelines were included: seven are Chinese guidelines, two are US guidelines and the other two are European guidelines. The mean standardized domains scores of the AGREEⅡinstrument in assessing the overall guideline quality were as follows: 50.13% for scope and purpose, 24.24% for stakeholder involvement, 18.51% for rigour of development, 54.03% for clarity of presentation, 11.36% for applicability and 30.30% for editorial independence. The recommendation level was B for five guidelines, and was C for the remaining six guidelines. The main recommendations involve three aspects: pharmacological intervention, non-pharmacological intervention, and continuing health management.

The overall methodological quality of included guidelines is unsatisfactory. To improve the quality of such guidelines developed in the future to better guide clinical practice, it is suggested to give more attention and priority to domains of stakeholder involvement, rigour of development, and applicability.

Vitamin D levels decrease with age and are associated with the occurrence of osteoporosis, fractures, falls and muscle weakness that are common in older adults. In addition, its association with quality of life in the elderly has also been increasingly paid attention.

To investigate the vitamin D level and its correlation with health-related quality of life in the elderly population dwelling in community in Beijing, and to provide decision-making reference for improving the full life-cycle quality of life of this population.

The data of this study were obtained from the BEYOND research database carried out in Chaoyang District and Fengtai District of Beijing from November 2017 to July 2018. A total of 1 066 elderly people aged ≥ 60 were included for analysis. Clinical information including demographic and socioeconomic characteristics, biochemical markers of bone metabolism, bone mineral density, left and right hand grip strength, sitting test, and history of falls and fractures during 2-year follow-up was collected. According to the level of 25-hydroxyvitamin D〔25 (OH) D〕, the subjects were divided into vitamin D deficient group, vitamin D insufficient group and vitamin D sufficient group, and the EuroQol Five-dimensional Questionnaire (EQ-5D) was used to evaluate the quality of life of the subjects.

Among the 1 066 subjects, 729 (68.39%) were in the vitamin D deficient group, 291 (27.30%) were in the vitamin D insufficient group, and 46 (4.32%) were in the vitamin D sufficient group. Serum levels of procollagen type 1 N-terminal propeptide (P1NP) , alkaline phosphatase (ALP) , parathyroid hormone (PTH) , osteocalcin (OST) , and cross-linked type I collagen carboxyl-terminal peptide (β-CTX) , left hip overall T value, right hip overall T value, and left hand grip strength were statistically significant among three groups (P<0.05) . There were significant differences in pain discomfort dimension and EQ-5D utility value among the three groups (P<0.05) . The EQ-5D utility value of vitamin D sufficient group was higher than that in both vitamin D deficient group and vitamin D insufficient group (P<0.05) . The results of multiple linear regression analysis showed that 25 (OH) D level was an influence factor of EQ-5D utility value in the elderly (P<0.05) .

The prevalence of vitamin D deficiency and insufficiency in the elderly in the community in Beijing was 68.39% and 27.30%, respectively. The level of vitamin D is positively correlated with bone mineral density, grip strength and EQ-5D total utility value in the elderly. Early screening of vitamin D levels in the elderly population and timely supplementation with adequate intakes are of great significance to maintain and improve the health-related quality of life in the population.

TCM manipulation is an important way for the treatment of cervical spondylosis. A large number of randomized controlled trials (RCTs) about TCM manipulation for cervical spondylosis have been published as relevant research develops. However, various levels of qualities of these RCTs may be non-beneficial to the promotion of TCM manipulation and the generation of high-quality clinical evidence.

To evaluate the quality of RCTs of TCM manipulation for cervical spondylosis.

We searched RCTs of TCM manipulation for cervical spondylosis in databases of CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase and Cochrane Library from inception to June 2021. RCTs enrollment and data extraction were performed by two researchers, separately. Quality assessment was conducted using the PEDro Rating Scale, The Cochrane Collaboration's tool for assessing risk of bias, and the CONSORT 2010 Statement and other six indicators (whether the RCT is multicenter, with ethical approval, informed consent, quality control for intervention, efficacy assessment criteria, and acknowledgement) .

Finally, 81 RCTs were included, of which 28 were published from 2006 to 2014, annually averaged 3.11, other 53 were published from 2015 to 2021, annually averaged 7.57. By the PEDro Rating Scale, the quality of only 7 (8.6%) RCTs was rated as high-quality (≥7 points) . By the Cochrane Collaboration's tool for assessing risk of bias, the percentage of RCTs with high risk of bias was the least, followed by that of those with low risk of bias. Most of RCTs had unclear risk of bias due to reported incomplete information. By the CONSORT 2010 Statement, the rates of title, abstract, methods, results, discussion and other information reported by the included RCTs were insufficient. By other six indicators, the rate of RCTs with a multicenter design, ethical approval, quality control for intervention, and acknowledgement was low.

The quality of current RCTs about TCM manipulation for cervical spondylosis is generally low. The improvement recommendation for relevant researchers is writing RCTs about the TCM manipulation for cervical spondylosis standardly in accordance with the PEDro Rating Scale, the Cochrane Collaboration's tool for assessing risk of bias, and the CONSORT 2010 Statement.

Health-related quality of life (HRQoL) is a key indicator that is used for evaluating clinical outcomes. Infertility-specific HRQoL instruments have been widely used, but it is uncertain whether these instruments have good measurement properties in clinical application, and there is a lack of quality evaluation for them.

To perform a systematical review and evaluation of HRQoL instruments in infertility patients, offering a rational reference for the selection of these instruments.

In October 2020, PubMed, Web of Science, the Cochrane Library, EmBase, CNKI, WanFang Data, CQVIP, and SinoMed databases were searched from inception to October 5, 2020 to identify studies on HRQoL instruments designed for or assess HRQoL for patients with infertility. Two reviewers independently implemented literature screening, data extraction, and methodological quality assessment of the included studies in terms of the process of developing infertility-specific HRQoL instruments and measurement properties of the instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Descriptive analysis was used to summarize and analyze the assessment results.

We included 229 studies on 19 HRQoL instruments, including 4 infertility-specific HRQoL instruments〔TLMK (Tübinger Lebensqualit?tsfragebogen für M?nner mit Kinderwunsch) , the Fertility Quality of Life (FertiQoL) , Quality of Life in Infertile Couples Questionnaire (QOLICQ) , Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory〕, 4 cancer-specific or other disease-specific HRQoL instruments and 11 generic HRQoL instruments. The FertiQoL was the most frequently used in existing studies〔39.1% (91/233) 〕. Regarding the development of PROMs, of the 4 infertility-specific HRQoL instruments, except for the FertiQoL instrument, whose overall development quality was considered "doubtful", the overall development quality of the other three instruments was considered "inadequate". In terms of the content validity, the methodological quality of the studies on FertiQoL and QOLICQ development was rated "very good" and "doubtful", respectively, while that of the study on the TLMK or Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory scale development was rated "adequate". In terms of the construct validity, except for the study on QOLICQ development, which was of "doubtful" methodological quality, the methodological quality of studies on the other three instruments development was considered "adequate". And the construct validity was rated "indeterminate" for all these 4 instruments. In terms of the internal consistency, the methodological quality of studies on the development of the 4 instruments was rated "very good", and the internal consistency of the 4 instruments was rated "sufficient". Regarding the test-retest reliability, the methodological quality of the study on QOLICQ development was considered "doubtful" and the test-retest reliability of the instrument was rated "indeterminate". The methodological quality of studies on the Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory scale development was rated "very good" in terms of criterion validity, and the criterion validity of the instrument was rated "sufficient". The methodological quality of the study on TLMK instrument development was rated "very good" in terms of criterion validity, and the criterion validity of this instrument was rated "sufficient". As for responsiveness/sensitivity, the methodological quality of the study on FertiQoL development was rated "very good", and the responsiveness/sensitivity of the instrument was rated "sufficient".

The methodological quality of the study on the development of FertiQoL and the measurement properties of the instrument were much higher. The number of Chinese infertility-specific HRQoL instruments is insufficient and needs more relevant studies.

The pairwise correlation among biased constitution, exercise and health-related quality of life (HRQOL) has been extensively studied, while the relationship among the three has been rarely explored.

To explore the mediating effect of exercise on the relationship of 8 kinds of biased constitution with HRQOL.

By use of convenience sampling, unpaid blood donors and their companions were selected as participants from blood donation cabins and blood collecting vehicles of Beijing Red Cross Blood Center from July to November 2015 and May to September 2016 . The exercise level was obtained by the self-report method. The biased constitution was assessed using the Constitution in Chinese Medicine Questionaire (CCMQ) . The HRQOL was evaluated by the Chinese version of the 36-Item Short Form Health Survey (SF-36) , and a higher score indicates a higher quality of life. Pearson correlation analysis was used to explore the correlation among HRQOL (score of SF-36) , exercise level and 8 kinds of biased constitution. Multiple linear regression model was applied to explore the mediating effect of exercise on the relationship between HRQOL and biased constitution.

A total of 1 828 cases attended the survey, 1 771 of them returned questionnaires, and after excluding 29 who inappropriately (incompletely or illogically) answered questionnaires, the remaining 1 742 cases (95.30%) were included for analysis. The mean SF-36 score of 1 742 subjects was (84.42±12.05) points. And the mean scores of the 8 biased constitution subscales of CCMQ for them were: qi-deficiency: (23.20±14.61) points, yang-deficiency: (20.03±18.12) points, yin-deficiency: (20.87±15.20) points, phlegm-dampness: (19.78±14.65) points, dampness-heat: (21.70±16.57) points, blood-stasis: (17.68±14.08) points, qi-depression: (19.63±15.63) points, specific-diathesis: (15.30±13.62) points. The score of each of the 8 kinds of biased constitution was negatively correlated with HRQOL (r: -0.413 - -0.612, P<0.01) . Except for specific-diathesis type, biased constitution scores were negatively correlated with exercise level (r: -0.072 - -0.176, P<0.01) . Exercise level was positively correlated with HRQOL (r=0.145, P<0.01) . Mediation analysis revealed that, exercise played a significant mediating effect on the relationship between HRQOL and biased constitution except the specific-diathesis type (P<0.05) . And the size of mediating effect in a descending order was 2.13% between HRQOL and phlegm-dampness, 2.05% between HRQOL and yang-deficiency, 1.88% between HRQOL and dampness-heat, 1.55% between HRQOL and yin-deficiency, 1.48% between HRQOL and blood-stasis, 1.37% between HRQOL and qi-depression, 1.16% between HRQOL and qi-deficiency.

Eight kinds of biased constitution (phlegm-dampness, yang-deficiency, dampness-heat, yin-deficiency, blood-stasis, qi-depression, qi-deficiency, and specific-diathesis) negatively affected the HRQOL. Although exercise partially played a role in mediating the relationship of HRQOL with the other 7 types of biased constitution except specific-diathesis, the effect size was generally little.

Nephrotic syndrome (NS) is a common chronic kidney disease in children, and has a long treatment cycle with being prone to recurrence and refractoriness. Adverse effects caused by therapeutic drugs and concerns about disease prognosis may all affect the child's physical and mental health, and quality of life. Therefore, it is very necessary to understand the Health-related Quality of Life (HRQOL) of children with nephrotic syndrome.

To understand the level of HRQOL in children with nephrotic syndrome.

Children (aged 2-18 years) with nephrotic syndrome and their parents were recruited from the Department of Pediatric Nephrology Rheumatism and Immunology, Shengjing Hospital of China Medical University between October 2019 and December 2020. Data were collected on age, gender, disease duration, whether they had frequent relapses, number of relapses, and whether they were prescribed immunosuppressive agents (including cyclophosphamide, tacrolimus, etc.) , place of residence (urban, rural, urban-rural junction areas) . The PedsQL 4.0 core generic scale was used to understand the level of HRQOL (including the child self rating scale and parent report) in children with primary NS.

A total of 183 questionnaires were distributed, and 174 valid questionnaires were returned, with an effective recovery rate of 95.1%. Among the 174 children, 119 were males and 55 were females. Median age was 6 (4, 11) years. There were 100 children with recurrence (57.5%) , with a median number of 3 (1, 5) recurrences. 54 patients had frequent recurrences and 46 patients had non frequent recurrences. 31 patients were treated with immunosuppressants. The usual place of residence was urban in 86 patients, rural in 63 patients, and urban-rural junctions in 25 patients. The ICC of the concordance analysis between the children's self-rating scale and the parent-reported scale were both greater than 0.75. There were no significant differences in physiological scores, emotional scores, social scores, role scores and total scores between genders (P>0.05) . There were statistically significant differences in physiological scores, emotional scores, social scores and total scores among different ages (P<0.05) . However, there was no significant difference in the role scores at different ages (P>0.05) . There were no significant differences in the physiological scores, emotional scores, social scores, role scores, and total scores among different disease durations (P>0.05) . There were no significant differences in the physiological score, emotional score, social score, role score and total score between children with and without frequent recurrence (P>0.05) . The emotional scores, social scores, and total scores were significantly different between children who used immunosuppressants and those who did not use (P<0.05) , and those who did not apply immunosuppressants achieved a higher score. There were no significant differences in the physiological scores, emotional scores, social scores, role scores and total scores among different family residing places (P>0.05) .

The scores of children with NS in physical, emotional, social, and role functioning were reduced. When treating the disease, clinicians need to focus on the children's physical, psychological and social adaptability, and intervene in time to improve their quality of life.

Chronic diseases have become an important public health problem that affects the economic and social development of country and population health. Quantifying the disease and economic burden of the elderly can provide a better understanding of the impact of chronic diseases on individuals and society.

To understand the prevalence of common chronic diseases among the elderly in Shanxi Province and explore the quality-adjusted life year (QALY) loss and economic loss which caused by chronic diseases.

From June to August in 2019, a multi-stage random sampling method was used to select 3 250 elderly people aged≥ 60 years from 11 cities in Shanxi Province as the research subjects for a questionnaire survey. The questionnaire included general demographic information, disease status survey, and health-related quality of life status. The European Five-Dimensional Health Scale (EQ-5D-5L) was used to assess the health-related life quality of the elderly. The QALY loss caused by chronic diseases was calculated based on the Chinese EQ-5D-5L utility value score system, and the QALY loss and economic loss caused by common chronic diseases in Shanxi Province in 2019 were estimated by using population and GDP per capita from statistical bulletin.

The results of univariate analysis showed that there were significant differences in the utility value of EQ-5D-5L among the elderly with different ages, living regions, educational levels, marital status, and family per capita monthly income (P<0.05) . The results of multiple linear regression analysis showed that higher per capita monthly income of families, being married and younger age were the protective factors for the health utility value of EQ-5D-5L (P<0.05) . The prevalence of chronic diseases among the elderly in Shanxi Province was 58.49% (1 901/3 250) . The top 5 chronic diseases by prevalence were: hypertension 29.45% (957/3 250) , diabetes 10.83% (352/3 250) , rheumatism or rheumatoid arthritis 10.28% (334/3 250) , hearing impairment 8.09% (263/3 250) , gastritis or peptic ulcer 6.49% (211/3 250) . Based on the estimation of the total population of Shanxi Province, the loss of QALY caused by five common chronic diseases in Shanxi Province in 2019 was 2 078 685 years, and the economic loss was 95 045 792 940yuan. The chronic disease causing the most QALY loss and economic loss in Shanxi Province was rheumatism or rheumatoid arthritis in Datong, Taiyuan and Luliang; in Jincheng, Yangquan city was hearing impairment; In Jinzhong, Linfen, Yuncheng, Shuozhou, Xinzhou, Changzhi City was hypertension.

The prevalence of chronic diseases among the elderly in Shanxi Province was relatively high, and chronic diseases will not only cause the loss of QALY of the elderly, but also cause a huge economic burden. Common chronic diseases vary by region in Shanxi Province, each region should determine the priority of disease prevention and treatment according to the actual situation, identify the key objectives and population of health management, so as to achieve a multiplier effect.

Birth weight is closely related to individual health. Low birth weight is a high-risk factor for early neonatal death. Macrosomia is associated with higher risk of maternal and infant complications and various chronic diseases in adulthood. Therefore, it is very important to identify the influencing factors of neonatal birth weight.

To investigate the relationship between maternal intestinal flora and neonatal birth weight.

Participants were 516 singleton mothers and their babies〔24 with low birth weight (LW group) , 479 with normal birth weight (NW group) and 13 with macrosomia (OW group) 〕 delivered at term in Guangzhou Women and Children's Medical Center from January to September 2017. Maternal intestinal flora and clinical laboratory test parameters were collected, and the composition and diversity of intestinal flora were analyzed using QIIME. LEfSe analysis was used to compare the relative abundance of intestinal flora at the genus level of the mothers of three groups of babies to identify the flora with significant intergroup differences. MaAslin was used to assess associations of maternal laboratory test parameters and microbial genera. The Boruta was used to build models for predicting three types of neonatal birth weight using maternal laboratory test parameters and intestinal flora OTUs, to assess the association of maternal intestinal floras and neonatal birth weight.

The analysis of maternal intestinal floras showed that the abundance of Firmicutes was the highest at the phylum level, and Faecalibacterium was significantly enriched at the genus level. There were no significant differences in Simpson's Diversity Index and Shannon Diversity Index at the phylum level across the maternal intestinal floras of three groups of babies (P>0.05) . LEfSe analysis found that compared with intestinal flora of mothers of LW group, the intestinal flora of mothers of NW group showed significantly enriched Streptococcus and Roseburia (P<0.05) , and significantly reduced abundance of Bacillaceae, Raphanus, Methanosphaera, Barnesiella and Paraprevotella (P<0.05) , while the intestinal flora of mothers of OW group demonstrated significantly enriched Closrtidiaceae and Alistipes as well as significantly reduced abundance of Barnesiella (P<0.05) . Compared with intestinal flora of mothers of NW group, the intestinal flora of mothers of OW group indicated significantly enriched Megamonas, Coprococcus, Veillonellaceae, cc-115, Closrtidiaceae and Alistipes, and significantly reduced abundance of Blautia and Eggerthella (P<0.05) . The area under ROC curve (AUC value) based on laboratory test parameter OTUs model and intestinal flora OTUs model was 0.62 and 0.77, respectively, in discriminating LW from NW, and was 0.65, and 0.78 respectively, in discriminating OW from NW.

Neonatal birth weight varied by the features of maternal intestinal floras. The OTUs model based on maternal intestinal flora could distinguish the neonatal birth weight. Maternal intestinal flora may be a good predictor of neonatal birth weight.

Since the number of chronic disease patients is increasing, relevant prevention and treatment services have become important long-term tasks for primary care institutions. However, problems in the provision of primary care services seriously affect the perception of such services in residents, especially chronic disease patients.

To understand chronic disease patients' assessment of the quality of primary care services, providing evidence for improving the quality of chronic disease management services in primary care.

A survey was conducted between July and August, 2020 with chronic disease patients (n=630) selected from primary care settings in Guangdong's Chaozhou by use of multistage stratified random sampling. The Primary Care Assessment Tool-Adult Simplified Version (PCAT-AS) (consists of 10 domains, including first contact accessibility, coordination, ongoing, comprehensiveness, community orientation and other 5 domains) was used in the survey for understanding chronic disease patients' assessment of the quality of primary care services. Multiple linear regression was adopted to identify factors potentially associated with the PCAT-AS score.

Altogether, 553 cases (87.8%) who returned responsive questionnaires were enrolled for analysis. The average total PCAT-AS score for all respondents was (95.88±13.44) . The top three domains ranked in terms of average standardized score were comprehensiveness (services needed) (7.89) , first contact accessibility (7.72) , and first contact utilization (7.58) , and the bottom three-ranked domains were coordination (referrals) (5.61) , community orientation (6.11) and patient and family centeredness (6.40) . Multiple linear regression analysis indicated that higher total PCAT-AS score was associated with living in urban areas in contrast to rural areas〔b (95%CI) =-6.983 (-10.598, -3.368) 〕, senior high school and higher education level instead of junior high school and lower education level〔b (95%CI) =4.046 (0.966, 7.125) 〕, permanent residents without the local hukou in contrast to those with local hukou〔b (95%CI) =-5.360 (-9.517, -1.202) 〕, good self-rated health instead of relatively poor self-rated health〔b (95%CI) =-4.962 (-8.438, -1.486) 〕 or poor self-rated health〔b (95%CI) =-7.787 (-12.789, -2.786) 〕, having a contracted family doctor instead of having no contracted family doctor〔b (95%CI) =4.686 (2.508, 6.865) 〕, first choosing a community health center for treating common diseases instead of a village clinic〔b (95%CI) =-5.865 (-9.951, -1.779) 〕 or a district/county-level hospital or tertiary hospital〔b (95%CI) =-6.061 (-11.330, -0.792) 〕, 4-6 primary care visits instead of 1-3 primary care visits〔b (95%CI) =5.876 (3.367, 8.384) or 7 or more primary care visits instead of 1-3 primary care visits〔b (95%CI) =9.045 (6.512, 11.579) 〕, and high satisfaction with primary care services instead of fair satisfaction〔b (95%CI) =-2.844 (-4.817, -0.870) 〕 or dissatisfaction〔b (95%CI) =-10.418 (-17.050, -3.786) 〕.

Overall, Chaozhou chronic disease patients reported a sound level of treatment experience in primary care. Specifically, they reported good primary care experience in three domains, including comprehensiveness, first contact accessibility and first contact utilization, but poor experience in community orientation, and coordination (including information systems and referrals) . However, urban patients reported better primary care experience than rural patients. So continued efforts are needed to strengthen primary care performance in rural areas.

HIV/AIDS is an issue that seriously endangers public health. With the implementation of social support policies for people living with HIV/AIDS, although the mortality of them has decreased significantly, their survival is still a big concern.

To understand the quality of life and influencing factors in people living with HIV/AIDS in Henan rural areas.

By use of cluster sampling, we selected the persons living with HIV/AIDS treated by highly active antiretroviral therapy (HAART) who were managed by the local center for disease control and prevention in a rural area of Henan from June 3 to June 12, 2020. We collected their general data and laboratory test findings, and assessed their quality of life using the Chinese version of the WHOQOL-HIV BREF. We used multiple linear regression to identify the associated factors of quality of life.

A total of 415 cases attended the questionnaire survey, and 400 of them (96.39%) who effectively completed the questionnaire were finally included for analysis. All the respondents were Han people, most of them were diagnosed over eight years, males, and aged over 50 years, and had a spouse, no stable income, low education level and CD₄⁺ T lymphocytes greater than 500/μl with transmission mainly through blood, and over eight years of continuous HAART. The total score of quality of life of the respondents differed by sex, age, education level, marital status, income status, route of getting HIV infection, time of HIV diagnosis, and continuous treatment duration of HAART (P<0.05) . Multiple linear regression analysis indicated that age (β'=-0.152) , marital status (β'=0.171) , income status (β'=-0.138) , and route of getting HIV infection (β'=0.104) were associated with the quality of life (P<0.05) .

Special attention should be given to the quality of life of people living with HIV/AIDS infected by blood contact with an age of over 50 years, no spouse, and no stable income.

Cardiopulmonary problems will increase the risk of health harms yet they are often neglected in clinical rehabilitation treatment for stroke patients. In addition, sleep problems also often affect the rehabilitation effect in these patients, while routine drug treatment could not achieve satisfactory effect.

To assess the effect of precisely prescribed exercise on cardiopulmonary fitness and sleep quality in stroke patients.

Sixty-four stroke inpatients were recruited from Rehabilitation Department, Changzhou Dean Hospital from April 2020 to August 2021, and equally randomized into a control group and an experimental group. At baseline, cardiopulmonary fitness was assessed using cardiopulmonary exercise testing (CPET) , and sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) for both groups. Then control group received 12-week routine rehabilitation training, while experimental group received 12-week routine rehabilitation training plus aerobic exercise precisely prescribed based on baseline CPET parameters. Intra- and inter-group comparisons were made between pre- and post-training major CPET parameters, dyspnea and leg fatigue measured by the Borg Scale and sleep quality.

At the end of training, the experimental group demonstrated higher peak oxygen uptake (VO₂peak) , percentage of predicted peak oxygen uptake (VO₂peak%pred) , peak metabolic equivalent (METpeak) , peak heart rate (HRpeak) , peak load, and anaerobic threshold (AT) , and lower intensity of perceived dyspnea and leg fatigue than the control group (P<0.05) . The above-mentioned eight parameters improved significantly after training in the experimental group (P<0.05) . The experimental group had lower post-training scores of six domains (subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleep medication, daytime dysfunction) and lower post-training total score of PSQI than the control group (P<0.05) . The total score of PSQI and the scores of its seven domains were all lowered significantly when the training was finished (P<0.05) .

The precisely prescribed aerobic exercise by the results of CPET could effectively improve the cardiopulmonary fitness, exercise intensity, exercise endurance, and sleep quality as well as the sense of exercise fatigue in stroke patients.

Identifying insulin resistance (IR) is of important clinical value as it is a pathological basis of multiple diseases, such as metabolic syndrome, type 2 diabetes, hypertension, and atherosclerosis. Numerous previous studies have suggested that excessive gain of fat is closely associated with IR. Dual-energy X-ray absorptiometry is often clinically used as the golden standard for measuring human body fat, but its health economic cost is high.

To assess the associations of predicted fat mass (pFM) and predicted fat percent (pFP) with IR in a middle-aged and elderly population without diabetes in Chengdu.

In May 2007, a cross-sectional survey was conducted by trained medical workers in Chenghua District, Chengdu, Sichuan. A total of 711 middle-aged and elderly individuals were selected as surveyees by random cluster sampling, and 570 of them were included for analysis after excluding 141 with diabetes. The survey includes filling in a standardized questionnaire, a physical examination, and a laboratory test. The homeostasis model assessment of IR (HOMA-IR) , pFM, and pFP were calculated.

Among the 570 subjects, the range of HOMA-IR was from 0.01 to 5.50, with a median value of 1.05 (0.72, 1.53) ; the range of pFM was from 2.34 to 41.41 kg, with a value of mean (SD) of (18.59±6.47) kg; the range of pFP was from 13.95% to 48.46%, with a median value of 28.97 (23.77, 37.39) %. The prevalence of IR was 20.17% (115/570) . The results suggested the HOMA-IR value and IR prevalence increased with the increase of pFM and pFP (P<0.001) . Multivariate Logistic regression analysis indicated that both pFM〔OR=3.22, 95%CI (2.45, 4.33) 〕 and pFP〔OR=3.51, 95%CI (2.61, 4.84) 〕 were associated with IR (P<0.05) . For predicting IR, the area under the receiver operating characteristic curve (AUC) was 0.777〔95%CI (0.733, 0.822) 〕with 38.10 kg as the optimal cut-off value for pFM, and 0.719〔95%CI (0.668, 0.769) 〕with 17.74% as the optimal cut-off value for pFP, respectively. And the AUC for four common traditional anthropometric indicators, namely waist circumference, body mass index, waist-to-height ratio (WHtR) and a body shape index (ABSI) was 0.749〔95%CI (0.700, 0.798) 〕, 0.753〔95%CI (0.706, 0.801) 〕, 0.768〔95%CI (0.722, 0.815) 〕, and 0.618〔95%CI (0.561, 0.675) 〕, respectively. Especially, the AUC of pFM or pFP was greater than that of ABSI (Z=4.452, P<0.001; Z=2.486, P=0.013) .

In this middle-aged and elderly non-diabetic population of Chengdu, pFM and pFP were independently associated with IR, and also could well discriminate IR. But pFM and pFP was only superior to ABSI.

Weight management should be extended to the entire population and not limited to special populations. Exploring the willingness, status, measures and influencing factors of adults' weight management, may contribute to the development of a reasonable, scientific, and easily operable method for reaching or maintaining a healthy weight.

To understand the prevalence and associated factors regarding achieving or maintaining a healthy weight in residents aged 18-79 in Beijing.

A survey was conducted from August to December 2017 with a stratified multistage sample of 13 188 permanent residents aged 18-79 from Beijing's 16 districts using a self-compiled questionnaire for understanding their self-assessed weight, weight changes within the past 12 months, and use of methods for weight control. The prevalence of weight management was compared by different characteristics. Methods for weight management used by weight controllers were comparatively analyzed by sex and age. We explored the differences in daily dietary habits and physical activity between weight controllers and non-weight controllers. Multivariate Logistic regression was used to analyze the factors associated with the implementation of weight management.

The overall prevalence of weight management in the residents over the last 12 months was 29.90% (3 947/13 188) . The prevalence of weight management differed statistically by sex, marital status, level of education, diabetes prevalence, current smoking status, physical activity status, voluntary health check-ups, assessment of weight, change in weight over the past 12 months, and BMI (P<0.05) . Diet control〔87.31% (3 446/3 947) 〕 and physical exercise〔78.34% (3 092/3 947) 〕were the most widely used weight management methods. The proportion of men who used physical exercise and smoking for weight control was significantly higher than that of women (P<0.001) , whereas the proportion of women who used diet control and weight loss medications for weight control was significantly higher than that of men (P<0.05) . The proportion of residents who used physical exercise and smoking for weight control was differed statistically by age groups (P<0.05) . 2 668 cases (67.60%) used both diet control and physical exercise to control weight, among whom 60-70 year olds accounted for a higher percentage than did 18-44 year olds and 45-59 year olds (P<0.001) . 625 cases (15.83%) relied only on diet control to control weight, among whom 18-44 year olds accounted for a higher percentage than did 45-59 year olds and 60-79 year olds (P<0.001) . The prevalence of weight management by physical activity or smoking differed significantly across age groups. Compared with non-weight controllers, weight controllers had lower prevalence of inadequate intake of fresh fruit and vegetables and excessive intake of red meat (P<0.05) . Moreover, they had higher prevalence of doing ≥ 150 min of moderate to vigorous intensity activities per week (P<0.001) . Furthermore, they had higher prevalence of spending ≥4 hours per day in leisure-time sedentary behaviors (P<0.001) . Multivariate regression analysis showed that age<60 years, women, married/unmarried cohabitation, higher level of education (junior high school and above) , current non-smoking, alcohol consumption within the past 7 days, physical inactivity, voluntary physical examinations, correctly assessing one's own weight, weight gain/loss ≥ 2.5 kg in the past 12 months, and having a BMI within the range of normal to obesity were associated with higher possibility of implementing weight management (P<0.05) .

In these Beijing residents aged 18-79 years, diet control and increased exercise were popular for weight control, but the use of unhealthy weight management methods was also found. When guiding residents to use proper methods to control weight, individualized management programs should be developed with sex, age, education level and other factors taken into consideration.