In 2016, American Association of Clinical Endocrinologists(AACE) published the guidelines for obesity and defined obesity as an adiposity-based chronic disease and obesity should be managed according to the obesity-related complications (16 complications are listed). Obesity intervention should be transferred from the purpose of weight loss to the intervention of metabolic disorder and its complications. The diagnosis and intervention of obesity in this guideline is sub- classified focus on the gender, region, and combined diseases, which is with more practical and scientific significances. This interpretation is expected to help the professional medical staffs to understand the new strategy in obesity therapy and to combine with the real world and clinical experience. New suggestions should put forward and improve the theories.

The new protein suppressors of cytokine signaling(SOCS) as negative regulators of signaling pathways involve in the cellular actions of many cytokines, including leptin. It regulates intracellular signal transduction cascades such as the JAK STAT pathway. SOCS is now evident of leptin resistance and has close relation with obesity. We reviewed the structure and function of SOCS 3 and the mechanism in leptin signaling pathway,providing data for the potential effect of SOCS 3 in the treatment of obesity.

Obesity has been widely accepted as a metabolic disease and its occurrence is closely related to the genetics, environment, and inflammation. Up to now, body mass index is still regarded as the standard diagnostic criterion for obesity. It has not been revised for decades and could not meet the needs of clinical diagnosis and demands for specific treatment at present. In 2013, the concept of metabolic obesity was introduced at the American Diabetes Association ( ADA) annual conference, and it was further proposed that obesity should be classified according to the metabolic status and its related complications at the 2014 American Association of Clinical Endocrinologists ( AACE) annual conference. This means that scientists and clinicians have realized that the etiology of obesity may vary with different outcomes, the treatment should be focused on the metabolic regulation, not merely on weight loss. With years of clinical practice and research in obesity, we have observed and treated numerous obese patients, and we have found that obesity has a lot of phenotypes and clinical features which are related to the metabolic status. Based on our clinical findings, combined with the experience of Chinese traditional medicine, we now propose a new clinical classification and diagnosis of obesity based on individuals′ metabolic status, which, we believe, can facilitate clinicians′practice. Based on the metabolic status and skin features of obese patients, obesity is divided into metabolic healthy obesity (‘white obesity’) and metabolic unhealthy obesity. Then, the latter is further divided into three groups including high metabolic obesity (‘red obesity’ ) , low metabolic obesity (‘yellow obesity’ ) , and severe metabolic disorder with inflammation obesity (‘black obesity’ ) . If we also consider to add normal weight metabolic obesity to this classification, there should be five types of obesity to be classified as presented. We wish this proposed classification of obesity can play a valuable role in enabling clinicians to have a better understanding of obesity in relation to its metabolism, and to develop individualized treatment according to the metabolic status of the patient. As a result, we may finally achieve the desired outcomes through making appropriate diagnosis and treatments.

The rat model of obesity was induced by high fat diet and in situ hybridization was performed with oligonucleotide probes.The results showed that expressions of leptin receptor mRNA and neuropeptide Y mRNA were significantly increased, suggesting that these increments might be related to leptin resistance.

Hyperthyroidism with periodic paralysis is common in clinic,the curative effect of peroral drugs on it is not satisfactory. In order to evaluate the treatment of 131 I for periodic paralysis in patients with hyperthyroidism, fouty two patients with hyperthyroidism complicated with periodic paralysis were put on p.o. 5.0 9.0 mCi 131 I Na treatment and the remission rate of periodic paralysis was observed.The total effective rate was over 95%. It can be concluded that 131 I could be used as a routine therapy for periodic paralysis in most patients with hyperthyroidism for its safety and efficiency.

Metabolic syndrome, whose incidence is higher than that we have thought, has done great harm to people's health. This review is to introduce the recent advance in the defination,epidemiology,etiology,major risk factors,clinical diagnosis and treatment, etc . of metabolic syndrome.

OBJECTIVE:To explore the influential factors for plasma concentration of paliperidone palmitate injection for pa-tients with schizophrenia. METHODS:37 schizophrenia patients who used Paliperidone palmitate injection and took plasma concentra-tion monitoring in Wuxi Mental Health Center from Sept. 2012 to Jun. 2015 was selected,the results were statistically analyzed,and the influential factors were preliminary explored. RESULTS:Totally 37 times were conducted for the plasma concentration monitoring for paliperidone with the average plasma concentration of(17.72±13.46)ng/ml,and 24 times(accounting for 64.86%)in the range of(10-60 ng/ml);the average plasma concentration of male patients was lower than that of female patients,the difference was statisti-cally significant(P<0.05);there was no significant difference in the average plasma concentration among different ages(P>0.05);there was also no significant difference in plasma concentration/dose ratio in patients with different daily dose(P>0.05);the average plasma concentration of patients with combination treatment was higher than that of single drug,the difference was statistically signifi-cant(P<0.05);and there was no significant difference in the average plasma concentration of relieved patients and ineffective treat-ment patients(P>0.05). CONCLUSIONS:The plasma concentration of paliperidone palmitate is affected by age,combination treat-ment and other factors,clinic can optimize the therapeutic regimen based on monitoring results of plasma concentration and patients’ symptoms to promote the rational drug use.

Objective To compare the efficacies of electrothermal needle acupuncture versus nimesulide in treating knee osteoarthritis and the relieving effects of them on the pain and explore the possible mechanism of electrothermal needle treatment for knee osteoarthritis.Method Eighty patients with knee osteoarthritis were randomly allocated to electrothermal needle and Western medicine groups, 40 cases each.The electrothermal needle group received electrothermal needle therapy and the Western medicine group took nimesulide sustained-release tablets.The therapeutic effects were compared after thecompletionof treatment.Therelieving effects of the two treatments on the pain were evaluated using the Pain Visual Analogue Scale(VAS).Serum SOD and MDA were measured in all the subjects before and after treatment.Result The marked efficacy rate and the total efficacy rate for knee osteoarthritis were higher in the electrothermal needle group than in the Western medicine group.There was no significant post-treatment difference in the VAS pain score between the electrothermal needle and Western medicine groups.After treatment, serum SOD increased and MDA decreased in the electrothermal needle group and they did not change significantly in the Western medicine group.Conclusion Electrothermal needle therapy can well relieve the symptoms of knee osteoarthritis.Its relieving effect on the pain is equal to that of nimesulide.The mechanism of electrothermal needle treatment for knee osteoarthritis may be relatedto its improving bodilyoxidative stress levels.

OBJECTIVE:To establish the quality standard for Maikang mixture. METHODS:TLC was used for the qualitative identification of Paeonia lactiflora,Angelica sinensis,Ligusticum chuanxiong,Astragalus membranaceus,Schisandra chinensis and Ophiopogon japonicus. HPLC was used for the content determination of schisandrin:the column was Kromasil C18 with mobile phase of methanol-water (60∶40,V/V) at a flow rate of 1.0 ml/min,detection wavelength was 254 nm,column temperature was 40 ℃,and the infection volume was 20 μl. RESULTS:P. lactiflora,A. sinensis,L. chuanxiong,A. membranaceus,S. chinensis and O. japonicus showed clear spots and well separated. The linear range of schisandrin was 1-50 μg/ml (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 97.01%-98.58%(RSD=0.56%,n=6). CONCLU-SIONS:The established standard can be used for the quality control of Maikang mixture.

Observe under endoscope the effect s of raising effective rate on the treatment of duodenal bulbar ulcers by the addition of epidermal growth factor. The control group , 1 08 cases , was randomized from 234 cases of active duodenal bulbar ulcer. Oral omeprazole , 20 mg , in the murning , and amoxil , 0. 5g , t. i. d. were administered for 4 weeks. The treatment group , 1 26 cases , in addition to the above mentioned 2 drugs , epidermal growth factor , 20 ml ( 40?g) , was added orally each morning for 4 weeks , followed by en- doscopy. The therapeutic effect of treatment group was better than that of the control with very significant difference. The effective rate of control group was 84 . 26% , and that of the treatment group , 96. 03% , X~2 = 9. 82 ,P