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    05 May 2026, Volume 29 Issue 13
    Guidelines·Consensus·Standards
    Chinese Guidelines for the Treatment and Prophylaxis of Influenza in Primary Care (2025 Edition)
    WANG Yeming, ZHOU Qi, LI Jingya, CHEN Siying, WANG Junrui, DUAN Qinlei, CHEN Yaolong, CAO Bin, Respiratory Disease Branch of the Chinese Medical Association, Infectious Diseases Branch of Chinese Medical Association
    2026, 29(13):  1633-1644.  DOI: 10.12114/j.issn.1007-9572.2026.0005
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    Influenza is characterized by pronounced seasonality, rapid transmission, and a high risk of severe illness among high-risk populations. These features pose a substantial threat to public health. In primary healthcare settings, the substantial burden of influenza cases, combined with relatively limited diagnostic and therapeutic resources, creates a pressing need for standardized and actionable guidance. Historically, recommendations for influenza treatment and prophylaxis have largely relied on expert consensus in China, with a lack of systematic, evidence-based guidelines. In recent years, accumulating evidence on traditional antiviral agents such as neuraminidase inhibitors, as well as emerging agents targeting RNA polymerase, has expanded therapeutic options for influenza, underscoring the need to systematically update existing treatment recommendations. Accordingly, a multidisciplinary panel of Chinese experts developed the Clinical Practice Guidelines for the Treatment and Prophylaxis of Influenza in China (2025 Edition) following the Scientific, Transparent, and Applicable Rankings (STAR) framework. With primary healthcare institutions as the main application setting, this guideline focuses on antiviral therapy and prophylaxis, systematically summarizing and updating treatment indications, drug selection, dosing regimens, duration, and safety management across different populations. Specific recommendations are provided for key groups such as children and pregnant women. Indications and strategies for prophylaxis during seasonal epidemic peaks are defined. The guideline presents a total of 19 evidence-based recommendations, providing systemic and actionable guidance for the clinical management and prevention of influenza in primary healthcare settings.

    Interpretation and Discussion of the RACGP Guidelines for Preventive Activities: Promoting Physical Activity among the Working Population in General Practice
    CHEN Zhang, QIU Shanjiao, LI Anchun, HE Zhiguang, HUANG Wenjing
    2026, 29(13):  1645-1648.  DOI: 10.12114/j.issn.1007-9572.2025.0468
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    Against the background of the increasingly younger onset of non-communicable diseases, physical inactivity has become an important and modifiable risk factor affecting the health of the working population. Although physical activity promotion has been consistently emphasized in national health policies in China, clearer and more operational pathways are still needed to systematically embed physical activity advice into routine general practice. This article focuses on the core concept of "embedding physical activity into daily life" proposed in the 10th edition of the Guidelines for Preventive Activities in General Practice issued by the Royal Australian College of General Practitioners (RACGP). Drawing on the World Health Organization guidelines on physical activity and sedentary behavior, as well as evidence from domestic and international literature, the paper interprets and discusses the role of general practitioners in physical activity promotion, key practice considerations, and potential implementation pathways. Experiences from community-based general practice in Shenzhen are also discussed to examine the contextual application and practical relevance of this concept in health management among the working population. This article aims to provide practical reference for promoting physical activity within general practice settings.

    Commentary
    Perspectives on Key Issues of the General Practice Discipline Development in China
    YAN Wenxin, LIU Jue, LIANG Wannian
    2026, 29(13):  1649-1653.  DOI: 10.12114/j.issn.1007-9572.2025.0432
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    General practice is a core secondary clinical discipline that serves the construction of the primary healthcare system and the tiered medical care system. Its high-quality development aligns with the requirements of the "Healthy China 2030" initiative and is crucial for addressing major public health challenges such as population aging and the high prevalence of chronic diseases. This paper systematically explores the disciplinary positioning, core characteristics, development drivers, and current status of General practice. Furthermore, it proposes specific recommendations to advance the high-quality development of the discipline across six dimensions: theoretical innovation, methodological breakthroughs, service quality improvement, education and training enhancement, focus of research direction, and intensification of academic exchange. The aim is to provide theoretical support and practical references for building a basic healthcare system with Chinese characteristics and achieving the strategic goals of healthy China.

    Analysis of the Root Causes of Medical Errors in Primary Hospitals under the Perspective of Local Standards in Beijing and Suggestions for Improvement Measures
    ZHAO Tiefu, XU Xuemin, WANG Na, PENG Jie, TIAN Xuedi, ZHANG Bo, FENG Yan, MA Hanying, LIU Kai, LIU Huanhuan
    2026, 29(13):  1654-1659.  DOI: 10.12114/j.issn.1007-9572.2023.0761
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    Background

    In the mediation and handling of doctor-patient disputes in primary hospitals, in most cases, it is recognized that the medical party has made mistakes in the diagnosis and treatment behavior. It is an important responsibility for medical institutions and health administrative authorities to promptly detect and reduce or eliminate the occurrence of medical errors. Promoting the improvement and enhancement of medical quality in primary hospitals is of special significance. The promulgation of the local standard "Code Specification for Key Control Points of Medical Behavior" in Beijing has made it possible to analyze the root causes of standardization of medical errors in primary hospitals.

    Objective

    To explore the root causes of medical errors in primary hospitals under the perspective of local standards in Beijing and measures for improving medical quality.

    Methods

    We collected judgments from various levels of people's courts in Beijing from 2019 to 2022 regarding medical damage as a cause of action, involving medical errors in first level hospitals in Beijing, as the research object. We applied the Beijing local standard "Code Specification for Key Control Points of Medical Behavior" as the basis to summarize and analyze the root causes of medical errors, and provided improvement measures for improving medical quality.

    Results

    From 2019 to 2022, there were a total of 127 judgments/rulings involving first level hospitals in Beijing that identified faults in the hospital's diagnosis and treatment behavior, based on medical damage as the cause of action. Among the root causes, the top one was poor communication between doctors and patients (32 cases, 25.2%), followed by unstable treatment plans (31 cases, 24.4%), lack of medical record writing (23 cases, 18.1%), and exceeding the scope of practice (17 cases, 13.4%). The proportion of over-range practice fault in different hospital categories was statistically significant (P<0.05). The pairwise comparison within groups showed that the proportion of over-range practice fault in tertiary hospitals was higher than that in primary hospitals and secondary hospitals, and the difference was statistically significant (P<0.016) .

    Conclusion

    The main root causes of medical errors in first level hospitals under the perspective of local standards in Beijing are poor communication quality between doctors and patients, unstable formulation of treatment plans, non-standard medical record writing, and exceeding the scope of practice. Targeted correction can improve the medical quality of first level hospitals and safeguard the legitimate rights and interests of both doctors and patients.

    Article
    Analysis of the 8-year Trajectories and Influencing Factors of Medical-help-seeking Behavior of Hypertensive Patients
    WU Chunxiang, TIAN Jie, GUO Yi, DENG Bo, YU Jie, CAI Ning, SHEN Li
    2026, 29(13):  1660-1665.  DOI: 10.12114/j.issn.1007-9572.2024.0688
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    Background

    Hypertension has become a major health issue, impacting both health and quality of life. Due to its long course of illness, multiple and complex complications, and lack of a cure or correcting deviation, patients require lengthy and continuous support and medical management. Understanding the long-term journey and influencing factors of medical-help-seeking behaviour in hypertensive patients is crucial for developing targeted and patient-centred prevention and control strategies.

    Objective

    The study aimed to identify and analyze the long-term trajectories of medical-help-seeking behaviour among hypertensive patients who were managed by community health centres of Putuo District in Shanghai City. Using trajectory modeling to determine key behavioral patterns and the influencing factors, the study will inform hypertension prevention and treatment policies.

    Methods

    Continuous clinical records of 8 922 hypertensive patients were retrieved from Resident Electronic Health Record System of Putuo District in Shanghai from 2014 to 2021. The data include histories, encounters, diagnostic, management and follow-up information. The Group-Based Trajectory Model (GBTM) was applied to analyze the patterns of the medical-help-seeking behaviour change, simulate behavioural transitions, and identify the best fitting model. Analysis of variance and chi square test were employed to examine patient characteristics across diflerent behavioural trajectories. The persistently irregular medical-help-seeking behaviour' group served as the reference group for comparing influencing factors among medical-help-seeking behaviour trajectory groups.

    Results

    A total of 444 126 outpatient records were retrieved. The GBTM analysis revealed flve distinct medicalhelp-seeking behaviour trajectories: sustained regular (39.84%), regular with a slow decline (25.36%), U-shaped (11.43%), regular with slow increase (11.86%), and persistently irregular (14.86%). Statistical diverences were observed between these groups, including gender, age, illness duration, diabetes history, transient ischemic attack (TIA) history, and family history of high blood pressure, regular exercise habits (P<0.05). Female patients and those aged 75 years or older were more likely to transition from irregular to regular medical-help-seeking behaviour. Patients with diabetes or a history of TIA were less likely to follow irregular medical-help-seeking behaviour. Longer duration of hypertensive history and a family history were associated with a less favorable shift in behaviour.

    Conclusion

    Less than 40% of hypertensive patients consistently follow a regular medical-help-seeking behaviour. However, appropriate management strategies can promote regular medical-help-seeking behaviour, particularly in females, patients aged 75 years or above, and those with diabetes or a history of TIA. Further research is suggested identifying factors that can encourage medical help-behavioral changes in other medicalhelp-seeking behaviour trajectory groups.

    Clinical Efficacy of Chaihu Longgu Muli Decoction Combined with Cognitive Behavioral Therapy in the Treatment of Acute Insomnia of Liver Qi Stagnation with Fire Transformation Type
    YU Xuefang, ZHU Min, MA Qinglin, TAN Shenlang, WU Zixing, JIANG Wei
    2026, 29(13):  1666-1672.  DOI: 10.12114/j.issn.1007-9572.2025.0271
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    Background

    Acute insomnia with liver qi stagnation and fire transformation type originates from emotional imbalance, which disturbs the heart and causes sleeplessness. The treatment focuses on soothing the liver, relieving depression, clearing heat, purging fire, and calming the mind. Chaihu Longgu Muli Decoction has the effect of calming and soothing the mind, and Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first choice for non-drug treatment of insomnia. At present, there are few studies on Chaihu Longgu Muli Decoction combined with CBT-I in the treatment of acute insomnia with liver qi stagnation and fire transformation type.

    Objective

    The purpose of this study is to systematically evaluate the clinical effect of Chaihu Longgu Muli Decoction combined with CBT-I on acute insomnia patients with liver qi stagnation and fire transformation type.

    Methods

    From March 2023 to September 2024, 90 patients who met the diagnostic criteria of acute insomnia with liver qi stagnation and fire transformation type at the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army were selected as the research objects. According to the table of random numbers method, patients were divided into control group (45 cases) and observation group (45 cases). The control group received CBT-I intervention, while the observation group was treated with Chaihu Longgu Muli Decoction on the basis of CBT-I. Both groups received intervention for 4 weeks. Research evaluation indicators include: (1) Clinical symptom improvement [traditional Chinese medicine (TCM) syndrome score]; (2) Sleep quality parameters [Pittsburgh Sleep Quality Index (PSQI) score, photoplethysmography (PPG) monitoring indicators]; (3) Mood state indicators [Hamilton Anxiety Scale (HAMA) score, Hamilton Depression Scale (HAMD) score]; (4) Serum biomarker levels [Tumor Necrosis Factor-alpha (TNF-α), Interleukin-1beta (IL-1β), 5-Hydroxytryptamine (5-HT) ]; (5) Clinical efficacy and safety.

    Results

    The clinical total effective rate of the observation group [88.89% (40/45) ] was significantly better than that of the control group [66.67% (30/45), χ2=14.284, P<0.05]. Intra-group comparison showed that compared with before treatment, the total sleep time, sleep efficiency and 5-HT level in the two groups were significantly increased (P<0.05), while the sleep latency, awakening times, PSQI score, HAMA score, HAMD score, TCM syndrome score and inflammatory factors (TNF-α, IL-1β) levels were significantly decreased (P<0.05). The comparison between groups showed that the above indexes in the observation group were significantly better than those in the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (χ2=0.511, P>0.05) .

    Conclusion

    The combination of Chaihu Longgu Muli Decoction with CBT-I is safe and feasible for treating acute insomnia with liver qi stagnation and fire transformation type. It effectively improves patients' sleep quality, alleviates emotional disturbances, reduces TCM symptom scores, regulates neurotransmitter levels, and suppresses inflammatory responses. The therapeutic efficacy surpasses that of CBT-I alone.

    The Predictive Value of Age-adjusted Charlson Comorbidity Index for Sarcopenia in Older Adults
    YUAN Weixia, AO Panpan, MA Yun, WU Fengfu, XU Facui, YU Juan, ZENG Qun, WEI Shaofeng, YUAN Lijia
    2026, 29(13):  1673-1681.  DOI: 10.12114/j.issn.1007-9572.2025.0066
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    Background

    Sarcopenia is prone to increase the risk of hospitalization and death in elderly people, and its incidence is often higher in patients with multiple chronic diseases. Detecting comorbidities can detect and treat sarcopenia as early as possible, but previous studies have not fully considered the severity and combination of chronic diseases.

    Objective

    To analyze the association between age-adjusted charlson comorbidity index (aCCI) and the risk of sarcopenia in elderly patients, and explore a new predictive models for sarcopenia in the elderly.

    Methods

    Select 218 elderly patients who were treated at the 925th Hospital of Joint Logistics Support Force from December 2023 to May 2024. According to the diagnosis results, the patients were divided into two groups: sarcopenia group (n=69) and non-sarcopenia group (n=149). Collect basic patient information, blood biochemical indicators, muscle related indicators, Mini Nutritional Assessment Short-Form (MNA-SF), etc., and use aCCI to assess comorbidities. Using multiple Logistic regression analysis to investigate the association between aCCI and other factors with sarcopenia in elderly patients, and drawing receiver operating characteristic (ROC) curves to evaluate the predictive value of aCCI and scoring models for sarcopenia in elderly patients.

    Results

    The results of multiple Logistic regression analysis showed that elevated aCCI (OR=1.661, 95%CI=1.165-2.368, P=0.005) was a risk factor for sarcopenia in elderly patients, while elevated MNA-SF score (OR=0.682, 95%CI=0.506-0.920, P=0.012) and calf circumference (OR=0.543, 95%CI=0.413-0.714, P<0.001) were protective factors for sarcopenia in elderly patients. Based on the multiple Logistic regression model equation Logit (P) =20.174-MNA-SF score×0.382 calf circumference×0.611+aCCI score×0.507, a nomogram prediction model for the risk of sarcopenia in elderly patients was constructed. The ROC curve analysis of MNA-SF score, calf circumference, aCCI, and nomogram prediction models for predicting sarcopenia in elderly patients showed that the area under the ROC curve (AUC) of MNA-SF score, calf circumference, and aCCI for predicting sarcopenia in elderly patients was 0.733 (95%CI=0.654-0.813), 0.853 (95%CI=0.797-0.908), and 0.739 (95%CI=0.662-0.815), respectively. The AUC of the nomogram prediction model for sarcopenia in elderly patients was 0.919 (95%CI=0.878-0.959, P<0.001), with an optimal cutoff value of 0.37, sensitivity of 0.831, and specificity of 0.821.

    Conclusion

    Our findings suggest that elevated aCCI is a risk factor for sarcopenia in elderly patients, while elevated MNA-SF score and calf circumference are protective factors. And the nomogram prediction model based on MNA-SF score, calf circumference, and aCCI has high predictive value for sarcopenia in elderly patients, which can provide a basis for early screening and prevention of sarcopenia.

    A Qualitative Study on the Current Status of Chronic Pruritus Services for the Elderly in Community
    JIAO Shuting, ZHAO Yali
    2026, 29(13):  1682-1687.  DOI: 10.12114/j.issn.1007-9572.2024.0257
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    Background

    Chronic pruritus (CP) has become a significant health problem affecting the elderly in community settings. Community health service institutions plays a crucial role in chronic disease management, but the current state of medical services for elderly patients with CP is still unclear.

    Objective

    This study aims to explore the current status and challenges of CP services for the elderly in community settings, and to propose actionable recommendations for enhancing the comprehensive service capabilities of general practitioners.

    Methods

    Between April and May 2024, semi-structured in-depth interviews were conducted with general practitioners working in Beijing community health service institutions using purposive sampling. The interview guidelines were composed of several open questions, including outpatient consultations, current service provision, challenges encountered and suggestions for service improvement. Thematic framework analysis was used to analyze the data, and findings were reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) .

    Results

    A total of 15 general practitioners were interviewed. The interview themes included 4 main themes and 19 sub-themes, which were: (1) Current status of outpatient consultations: prevalent among elderly patients, diverse etiologies and significant impacts on health; (2) Service provision: drug therapy, health education, follow-up visits and drug dispensing; (3) Existing challenges: insufficient professional knowledge, lack of high-quality training, inadequate attention to CP, low patient awareness, underutilization of clinical guidelines, limited medical resources and insufficient service promotion; (4) Improvement suggestions: establishing a standardized pruritus management process, implementing needs-based training, integrating pruritus care into existing chronic disease management programs, fostering a supportive environment, developing traditional Chinese medicine services and promoting sub-specialties development.

    Conclusion

    There is an imbalance between the supply and demand for CP services for the elderly in community health settings. To address this, the feasible methods include strengthening physician training, establishing standardized diagnostic and treatment protocols, integrating pruritus management into chronic disease management programs, and developing high-quality clinical practice guidelines in primary care.

    Construction of Support Services List for Parents of Children with Autism Based on "Timing It Right" Theory
    SHEN Yong, ZHOU Jingying, WANG Xueping, JIA Meixiang, LIU Jiajia, ZHAN Haojian, WANG Lifang, YAN Hao, PENG Danyuan, YUE Weihua
    2026, 29(13):  1688-1698.  DOI: 10.12114/j.issn.1007-9572.2025.0034
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    Background

    Parents of children with autism have multi-dimensional support service needs such as information, emotion, and skills, and the support service needs are constantly changing.

    Objective

    To development a systematic supportive service checklist for parents of children with autism based on "Timing It Right" theory.

    Methods

    From January 2024 to February 2025, based on the summarized key points of support services from evidence synthesis and "Timing It Right" theory, combined with the qualitative research results of parental support service needs and the survey results of parents of children with autism, the first draft of the checklist was preliminarily formulated. The Delphi method was used to select 23 experts nationwide in China for two rounds of expert consultation, and the final draft of the list was formed after revising the content of the first draft according to the experts' opinions.

    Results

    In the two rounds of expert consultation, 23 and 20 questionnaires were distributed, and 20 and 20 valid questionnaires were recovered. The response rates in two rounds of expert consultation were 86.96% and 100.00% respectively, and the expert authority coefficients were 0.874 and 0.878 respectively. The average score of the five first-level items in the second round of expert consultation was 4.74-5.00 points, the average score of the 20 second-level items was 4.42-5.00 points, and the average score of the 63 third-level items was 4.50-5.00 points. The final version of checklist of supportive service checklist for parents of children with autism included five first-level items including event/diagnosis, stabilization, preparation, implementation and adaptation phases, 20 second-level items and 63 third-level items.

    Conclusion

    This study formed a supportive service checklist for parents of children with autism. The process of forming the checklist is scientific and reliable, which can provide a reference for clinical medical staff to carry out support services for parents of children with autism in different stages and dimensions, but the practical application effect still needs to be further verified.

    Research on the Construction and Application of a Community Intervention Model for Knee Osteoarthritis Based on Sports and Medicine Integration
    SHAO Wenjuan, CAI Keshu, JIA Xiao, ZHANG Yimin
    2026, 29(13):  1699-1705.  DOI: 10.12114/j.issn.1007-9572.2023.0651
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    Background

    With the development of the integration of sports and medicine, as well as the increasingly severe situation and harm caused by knee osteoarthritis (KOA), the sports intervention for KOA has received widespread attention. Community settings are considered the optimal location for KOA sports interventions, but existing community-based KOA interventions suffer from issues such as non-standard processes, unclear regulations, and incomplete content, highlighting the urgent need for standardized models.

    Objective

    To construct a community KOA intervention model based on the integration of sports and medicine, and to apply and evaluate this model.

    Methods

    Through literature review and on-site observation, a conceptual framework for community KOA intervention model based on the integration of sports and medicine was initially proposed. This framework underwent refinement via expert interviews to establish its constituent elements and application processes, resulting in the establishment of the final model. The model was then applied to 62 KOA patients treated at the Maigaoqiao and Xigang Community Health Service Centers in Nanjing from July to October 2022. Patients were randomly divided into a sports intervention group (n=21) and a health education group (n=41), both receiving an 8-week standardized treatment protocol. Outcome measures included the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index Questionaire (WOMAC), EuroQol Five Dimensions Questionaire (EQ-5D), 30-second chair stand test, and time up and go test (TUGT) .

    Results

    The community KOA intervention model based on the integration of sports and medicine established an interactive relationship between "sports" and "medicine" in terms of departments, personnel, technical means, etc., including 5 primary elements and 24 secondary elements. Application of the model yielded the following outcomes: in the sports intervention group, post-treatment WOMAC total score and scores across all dimensions, VAS score, and TUGT time were significantly reduced compared to pre-treatment (P<0.05), while the EQ-5D health index and 30-second chair stand repetitions were significantly increased (P<0.05). In the health education group, post-treatment WOMAC total score and scores across all dimensions, as well as VAS score, were significantly lower than pre-treatment (P<0.05), with a higher EQ-5D health index (P<0.05). Comparison between groups post-treatment revealed that the sports intervention group had significantly lower WOMAC total score, WOMAC joint function score, and VAS score compared to the health education group (P<0.05) .

    Conclusion

    The community KOA intervention mode based on the integration of sports and medicine effectively alleviates, pain and joint stiffness symptoms, improves lower limb muscle strength and balance ability, improves joint function, and enhances quality of life for KOA patients.

    Association between Health Physical Fitness and Successful Aging among Middle-aged and Elderly Adults in the Community
    ZHANG Yaping, ZHAO Xuhao, PANG Ting, HE Xindi, YUAN Changzheng, WEN Xu, LIU Zuyun, XU Xin
    2026, 29(13):  1706-1712.  DOI: 10.12114/j.issn.1007-9572.2024.0498
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    Background

    Successful aging helps to slow the process of social aging, and there is a lack of comprehensive research on the association between health physical fitness and successful aging.

    Objective

    To explore the relationship between health physical fitness and successful aging among community-dwelling middle-aged and elderly adults.

    Methods

    A cross-sectional study was conducted among older adults aged 50 years and older in Hangzhou City. Based on the successful aging model of low risk of disease and disability, high level of physical and cognitive function, and active social engagement, 895 community-dwelling middle-aged and elderly adults of different genders were classified into the successful aging group and the unsuccessful aging group, and the differences in health physical fitness such as physical shape, physical function, and physical quality were compared between these two groups. Binary categorical Logistic regression was used to analyze the association between health physical fitness and successful aging.

    Results

    Regardless of gender, the successful aging population had lower waist circumference, waist-to-hip ratio, BMI, and better lower limb strength compared to the unsuccessful aging population. The successful aging female population had lower systolic blood pressure and better endurance, balance, and upper extremity flexibility, whereas the successful aging male population had faster gait speed and better lower extremity flexibility (all P<0.05). After adjusting for age, education, visual impairment, smoking history, and alcohol consumption history, balance and lower limb strength were found to be significantly associated with successful aging in females, with corresponding ORs of 1.015 (1.003-1.028) and 1.080 (1.009-1.156), respectively. Whereas, in males, there was a significant association between lower limb strength and successful aging, with a corresponding OR of 1.119 (1.005-1.246) (P<0.05) .

    Conclusion

    Successful aging population is better than unsuccessful aging population in terms of body shape, physical function, and physical quality indicators, and the relationship between successful aging and health physical fitness varies in different genders. It is recommended to adopt appropriate health physical fitness management measures for different genders to promote the realization of successful aging.

    Summary of Best Evidence on the Management of Hearing Loss in Older Adults in Primary Health Care Settings
    LI Jing, JI Yan, SUN Liu, WANG Hanting, WU Jidong, LIU June
    2026, 29(13):  1713-1719.  DOI: 10.12114/j.issn.1007-9572.2025.0026
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    Background

    Primary healthcare institutions play a crucial role in the management of hearing loss in the elderly. However, the available evidence is extensive and fragmented, and there is currently no scientific or standardized clinical practice guideline.

    Objective

    To comprehensively review and analyze the best evidence on the management of hearing loss in community-dwelling older adults within primary health care settings, providing a reference for clinical practice and guideline development.

    Methods

    Systematic searches were conducted in BMJ Best Practice, UpToDate, International Guideline Collaboration, Medlive.cn, National Institute for Health and Care Excellence, World Health Organization, National Guideline Clearinghouse, Canadian Medical Practice Guidelines Network, Scottish Intercollegiate Guidelines Network, Ontario Nurses Association, Joanna Briggs Institute (JBI) Collaboration Centre Library, Cochrane Library, PubMed, Web of Science, CINAHL, CNKI, Wanfang Data, and China Biomedical Literature Database. The search covered all evidence related to the management of hearing loss in older adults, including clinical decisions, guidelines, systematic reviews, and expert consensus, published between January 2014 and September 2024. The best available evidence was summarized according to the JBI Evidence-Based Healthcare Center's grading system (2016 version).

    Results

    A total of 14 documents were included, consisting of 2 clinical decisions, 5 guidelines, 5 systematic reviews, and 2 expert consensus reports. 35 pieces of best evidence were identified, covering 8 key areas: clinical characteristics of hearing loss, screening, assessment, referral, support for hearing assistive devices, hearing rehabilitation training, social support and health education.

    Conclusion

    The best evidence for managing hearing loss in elderly individuals developed in this study provides evidence-based support for primary healthcare professionals, helping them manage elderly patients' hearing loss in a standardized and scientific manner, thereby improving their hearing health and overall well-being.

    Investigation Study on Older People's Willingness to Use Webcast Exercise Guidance: Based on the UTAUT Model and the Perceived Risk Theory
    XIANG Tong, HUANG Yafang, WU Hao
    2026, 29(13):  1720-1725.  DOI: 10.12114/j.issn.1007-9572.2023.0474
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    Background

    Previous studies on "internet+health management" for the elderly mainly focused on the willingness to use mobile health applications, with less attention to the webcast exercise guidance.

    Objective

    Based on the unified theory of acceptance and use of technology (UTAUT) model and the perceived risk theory, we investigated the older people's willingness to use webcast exercise guidance.

    Methods

    From April to August 2022, a convenience sampling method was used to select older people visiting the Fangzhuang Community Health Service Center in Fengtai District, Beijing, as the subjects, and a self-designed questionnaire was conducted face-to-face. The questionnaire mainly assessed older adults' intention to use webcast exercise guidance.

    Results

    A total of 390 questionnaires were distributed, and 376 valid questionnaires were collected, with a valid recovery rate of 96.4% (376/390). Of the 376 participants, 161 were men and 215 were women. The fit index of the modified UTAUT model was better than the acceptable standards, indicating a good fit. The structural equation model test results showed that, performance expectancy (β=0.424), effort expectancy (β=0.325), social influence (β=0.596), and facilitating conditions (β=0.204) had a positive impact on the elderly's intention to use webcast exercise guidance, respectively, while perceived risk (β=-0.634) had a negative impact (P<0.001) .

    Conclusion

    Based on the UTAUT model and the perceived risk theory, performance experience, effort experience, social influence, and facilitating condition all positively affect the elderly's willingness to use webcast exercise guidance, while perceived risk negatively affects the Unified theory of acceptance and use of technology; Perceived risk theoryelderly's willingness to use webcast exercise guidance.

    Article·General Practice Education
    Discussion on the Application of AI-based Simulated-scenario Standardized Patients in the Standardized Training Teaching of General Practice Resident Physicians
    ZHANG Hanyu, GU Jie, LIN Yingnan, HUANG Yanyan
    2026, 29(13):  1726-1731.  DOI: 10.12114/j.issn.1007-9572.2024.0610
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    In the current field of medical education, the application of new-generation information technologies such as virtual reality and artificial intelligence has become a highly discussed topic, gradually playing an important role in the cultivation of medical talent. In the standardized training of general practice residents, the application of virtual reality technology and artificial intelligence can provide strong support for the personalization and interactivity of the teaching process, offering new ideas and methods for the teaching model. This paper systematically discusses the current applications of artificial intelligence technology in constructing simulated scenario standardized patients both domestically and internationally. It also looks forward to the significant development and potential applications of artificial intelligence in the creation of standardized patients for simulated scenarios in the standardized training of general medicine residents.

    Application of Teaching Feedback and Reflective Learning in Standardized Training for General Practitioners
    LIU Juanjuan, SHI Guoqing, REN Jingjing
    2026, 29(13):  1732-1738.  DOI: 10.12114/j.issn.1007-9572.2024.0493
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    General practitioners are not only the "starting station" and "hub station" in the patient's medical treatment process, but also the key to implementing graded diagnosis and treatment is to cultivate the job competence of general practitioners. Standardized training for resident general practitioners is the main way to cultivate high-quality general practitioners, and it is also a key link in achieving the transformation from "medical students" to "doctors". The clinical performance of general practitioners in clinical practice requires timely and effective teaching feedback from teachers, in order to understand their own clinical abilities. Reflective learning can promote general practitioners to actively think and summarize their own learning process. Teachers are the facilitators and organizers of reflective learning, and the two complement each other, promoting students to learn on their own and continuously improving their self-learning ability. The First Affiliated Hospital of Zhejiang University School of Medicine's General Practice Training Base has developed the "General Practitioners Feedback and Reflection (GP-FR) Training Model" based on teaching feedback and reflective learning. This article explores the current application of teaching feedback and reflective learning in general practice residency training and provides a systematic introduction to the conceptual framework, core elements, and specific content of the "GP-FR Training Model".

    Investigation on the Current Situation and Training Demand of Community Doctors Participating in Science Popularization in Beijing
    FU Mingyuan, LIU Xinying, YU Xiaoyi, KONG Min, GE Caiying
    2026, 29(13):  1739-1744.  DOI: 10.12114/j.issn.1007-9572.2024.0216
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    Background

    With the aging population and the increasing number of patients with chronic diseases in China, health popularization has become crucial in enhancing public health awareness and improving quality of life. As an important force to improve public health knowledge, community doctors' popularization ability is of great significance for realizing the strategy of healthy China.

    Objective

    This study aims to investigate the current status and training needs of community doctors in urban and suburban areas of Beijing regarding their participation in science popularization, and to explore effective strategies for improving their science communication skills.

    Methods

    From April to May 2024, a self-designed online questionnaire was administered to community doctors in suburban Beijing. The questionnaire covers basic demographic characteristics, stages of science popularization behavior, motivations and barriers to participation, media preferences, and training needs. Descriptive statistics and intergroup comparisons were used to analyze the current state of science popularization practices among community doctors. Based on the data analysis, training needs were identified.

    Results

    A total of 744 questionnaires were distributed, and 668 valid responses were collected, yielding an effective response rate of 89.78%. Analysis of the stages of science popularization behavior revealed that 244 respondents (36.53%) were in the intention stage, 153 (22.90%) in the preparation stage, and 152 (22.75%) in the maintenance stage. Furthermore, 157 respondents (23.50%) reported being relatively familiar with the creation of health science popularization content, while 324 (48.50%) believed that community doctors' science popularization efforts have a considerable impact on patients' healthcare experience and health management. The primary reasons cited by community physicians for their reluctance to engage in science popularization activities were lack of time and energy (72.27%, 86/119), insufficient experience and competence in science communication (57.98%, 69/119), lack of policy support and incentives (56.30%, 67/119) and low financial compensation (56.30%, 67/119). In contrast, the main motivations for participation included a sense of responsibility as healthcare professionals (75.96%, 417/549), job requirements (71.22%, 391/549), personal interest in science popularization (71.04%, 390/549), and the desire to enrich both personal and professional life (59.74%, 328/549). Among the respondents, 544 (81.44%) expressed a desire to improve their science communication skills, yet only 291 (43.56%) had participated in relevant training. The major training needs identified included: techniques for writing popular science scripts (70.51%, 471/668) ; selecting relevant topics and accurately targeting audience needs (67.66%, 452/668) ; methods for translating scientific research findings into popular science content (63.47%, 424/668) .

    Conclusion

    Community doctors face multiple challenges in science popularization activities, including perceived lack of policy support and insufficient resource allocation. To enhance their science communication capabilities, it is recommended to strengthen policy advocacy, establish stable funding and resource investment mechanisms, conduct regular training programs for capacity building, and provide specialized training on the use of new media tools. These measures will help community doctors better leverage their advantages in community healthcare practice through effective health popularization.

    Article·Drug Use Guide
    A Systematic Review of the Current Situation and Influencing Factors of Medication Management for Patients with Severe Mental Disorders in China
    ZHAO Jingru, JU Yvfei, XU Xiaotong, LI Dan, MENG Jie, LI Hui
    2026, 29(13):  1745-1752.  DOI: 10.12114/j.issn.1007-9572.2024.0577
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    Background

    The medication management of patients with severe mental disorders has become an important task for primary medical institutions in China. However, there is currently a lack of a systematic review on the medication management of patients and the restrictive factors for their regular medication.

    Objective

    To systematically review the situation and influencing factors associated with medication management in Chinese patients with severe mental disorders, and to provide evidence-based evidence for optimizing patients' medication management.

    Methods

    CNKI, WanFang, VIP and PubMed Data were searched to collect cross-sectional studies on medication management in Chinese patients with severe mental disorders and discussing the influencing factors of regular medication. The search time limit was from the establishment of the database to August 2024. Two reviewers independently screened studies, extracted data and assessed the risk of bias of included studies. Meta-analysis was conducted on the management rate, standardized management rate, medication rate, and regular medication rate in the quantitative studies using Stata 17.0 software. At the same time, a qualitative summary analysis was conducted on the influencing factors of regular medication compliance among patients with severe mental disorders.

    Results

    A total of fifty-nine studies were included, among which 41 studies quantitatively reported four indicators of patients' medication management. The results of meta-analysis indicated that the management rate of patients with severe mental disorders in China was 91.0% (95%CI=89.0%-93.0%), the standardized management rate was 77.0% (95%CI=70.0%-83.0%), and the medication rate was 72.00% (95%CI=66.0%-79.0%). The rate of regular medication was 50.0% (95%CI=44.0%-56.0%). From 2014 to 2021, the management rate, standardized management rate, medication rate and regular medication rate of patients increased from 73.7%, 35.8%, 35.0% and 17.9% to 96.7%, 94.1%, 87.0% and 84.2%, respectively. The management rate remained at a similar level in the eastern (92.3%), central (94.4%) and western (92.0%) regions. The standardized management rate, medication rate and regular medication rate were all higher in the eastern (86.5%, 82.5%, 62.7%), and central (81.2%, 88.1%, 57.9%) regions compared to the western (73.8%, 64.5%, 38.2%) region. Moreover, 18 studies qualitatively reported the influencing factors of regular medication in patients with severe mental disorders. The summary analysis showed that the restrictive factors affecting patients' regular medication was complex and diverse, mainly coming from five aspects: patients themselves, family caregivers, community management, hospital diagnosis and treatment, and government support.

    Conclusion

    The medication management ability of patients with severe mental disorders in China has significantly improved in recent years, but the differences among different regions are still considerable. In the future, based on multiple restrictive factors affecting patients' regular medication, collaborative management should be carried out to achieve the goal connotation of mental health management in China.