Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To evaluate the clinical efficacy and safety of intensive insulin therapy in the pa-tients with acute myocardial infarction and provide guidance for improving the prognosis.Methods The articles involving the randomized controlled trials(RCT)focusing on the effects of intensive versus conventional insulin therapy on the clinical outcomes of the patients with acute myocardial infarction were retrieved from Cochrane,Embase,PubMed,CNKI,Wanfang Data,VIP,and CBM with the time interval from inception to October 2022.The data of each RCT were extracted and used for meta-analysis in RevMan5.4.Results A total of 8 arti-cles were included in this study,involving 726 patients(372 in the intensive insulin group and 354 in the nor-mal insulin group).The meta-analysis results showed that the intensive insulin group had lower incidence of major cardiovascular adverse events(RR =0.53,95%CI =0.44-0.64,P<0.001),lower all-cause mortality(RR = 0.51,95%CI =0.33-0.78,P =0.002),lower high-sensitivity C-reactive protein level on day 7(WMD =-2.00,95%CI =-2.17--1.83,P<0.001),higher left ventricular ejection fraction on day 30(WMD = 3.94,95%CI =2.45-5.43,P<0.001),and higher incidence of hypoglycemia events(RR =2.96,95%CI =1.12-7.83,P =0.030)than the normal insulin group.There was no significant difference between the two groups in terms of no-reflow event after percutaneous coronary intervention(RR =0.39,95%CI =0.14-1.13,P =0.080).Conclusion Intensive insulin therapy might be associated with more clinical benefits in the patients with acute myocardial infarction,while the conclusion remains to be confirmed by more studies.

Objective: To evaluate the accuracy and feasibility of coronary artery calcium score ( CACS) on virtual non-contrast scan ( VNC) images obtained from coronary artery CT angiography ( CCTA) scan with dual －layer spectral detector CT (SDCT) ． Methods : The data of 197 patients who underwent CCTA scan in hospital were analyzed retrospectively，and 88 patients with CACS ＞0 were further analyzed． Linear regression analysis of CACS and coronary artery calcium volume ( CACV) of true non-contrast (TNC) images and VNC images ( CACS-TNC， CACS-VNC，CACV-TNC，CACV-VNC) was performed to obtain linear regression equation and correction coefficients λ 1AVG and λ2AVG ．CACS-VNC and CACV-VNC were corrected by the corresponding regression equation and recorded as CCACS-VNC and CCACV-VNC，respectively．Spearman correlation coefficient was used for correlation analysis and Bland-Altman plot was used for consistency test．Mann-Whitney U test was used to compare the difference between the two groups. Results : For the total coronary artery，there was a strong correlation between CACS- TNC and CACS-VNC (rs = 0. 952，P ＜0. 001 ，λ 1AVG = 2. 19 ) ，CACV-TNC and CACV-VNC ( rs = 0. 954，P < 0. 001，λ2AVG = 1. 93) ．The results of Mann-Whitney U test showed that there was no significant difference between CACS-TNC and CCACS-VNC or between CACV-TNC and CCACV-VNC，and the Bland-Altman plot showed good consistency between CACS-TNC and CCACS-VNC ，CACV-TNC and CCACV-VNC． Conclusion VNC images based on SDCT can accurately measure CACS and be used for cardiovascular risk classification，which is expected to replace TNC scan and reduce the radiation dose of patients.

With the rapid increase of the microbiome samples and sequencing data,more and more knowledge about microbial communities has been gained.However,there is still much more to learn about microbial communities,including billions of novel species and genes,as well as count-less spatiotemporal dynamic patterns within the microbial communities,which together form the microbial dark matter.In this work,we summarized the dark matter in microbiome research and reviewed current data mining methods,especially artificial intelligence(AI)methods,for different types of knowledge discovery from microbial dark matter.We also provided case studies on using AI methods for microbiome data mining and knowledge discovery.In summary,we view microbial dark matter not as a problem to be solved but as an opportunity for AI methods to explore,with the goal of advancing our understanding of microbial communities,as well as developing better solu-tions to global concerns about human health and the environment.

l-cysteine is an important sulfur-containing α-amino acid. It exhibits multiple physiological functions with diverse applications in pharmaceutical cosmetics and food industry. Here, a strategy of coordinated gene expression between carbon and sulfur modules in Escherichia coli was proposed and conducted for the production of l-cysteine. Initially, the titer of l-cysteine was improved to (0.38±0.02) g/L from zero by enhancing the biosynthesis of l-serine module (serA^f, serB and serC^Cg) and overexpression of CysB. Then, promotion of l-cysteine transporter, increased assimilation of sulfur, reduction or deletion of l-cysteine and l-serine degradation pathway and enhanced expression of cysE^f (encoding serine acetyltransferase) and cysB^St (encoding transcriptional dual regulator CysB) were achieved, resulting in an improved l-cysteine titer (3.82±0.01) g/L. Subsequently, expressions of cysM, nrdH, cysK and cysIJ genes that were involved in sulfur module were regulated synergistically with carbon module combined with utilization of sulfate and thiosulfate, resulting in a strain producing (4.17±0.07) g/L l-cysteine in flask shake and (11.94±0.1) g/L l-cysteine in 2 L bioreactor. Our results indicated that efficient biosynthesis of l-cysteine could be achieved by a proportional supply of sulfur and carbon in vivo. This study would facilitate the commercial bioproduction of l-cysteine.
Escherichia coli/metabolism* ; Cysteine/metabolism* ; Bioreactors ; Sulfur/metabolism* ; Serine/metabolism*

Objective To simulate the interaction between the stent graft (SG) and the aortic wall with finite element (FE) analysis by considering the influence of residual stress field, so as to study the stent influence on stress distributions of the aortic wall. Methods The three-dimensional (3D) residual stress field was generated in an idealized bi-layered thick-wall aortic model via a stress-driven anisotropic growth model by reducing the transmural stress gradient. Upon virtually deploying the SG, the stress on the aortic wall was calculated. Results The 3D residual stress field, corresponding to an opening angle of 117.5°, was shown to reduce the transmural stress gradient in both the circumferential and axial directions. The maximum stress was found at the contact area between aortic wall and wave peak of the stent. At 20% oversize ratio of the stent, the maximum stresses on the aortic wall in circumferential and axial direction were 412 and 132 kPa, respectively, while the in-plane shear stresses σrθ and σrz were both 78 kPa. Under residual stress, the maximum radial, circumferential and axial stresses were decreased by 14.9%, 40.5% and 33.8%, respectively, while the maximum shear stresses σrθ ，σrz，σθz were reduced by 2.5%, 7.1% and 27%, respectively. With the increase of oversize ratio from 10% to 20%, the maximum radial, circumferential and axial stresses were increased by 316%, 129% and 41%, respectively, while the maximum shear stresses σrθ ，σrz，σθz were increased by 661%, 450% and 466%, respectively. Conclusions The residual stress can effectively reduce the transmural stress gradient. Both the residual stress and the oversize ratio of the stent play an important role in modulating the wall stress distribution and the maximum stress.

Objective: To evaluate the effect of Sacubitril/Valsartan for alleviating chronic heart failure(CHF)in elderly patients after acute myocardial infarction(AMI). Methods: A total of 87 elderly patients with AMI-induced CHF treated in Heze Shili Hospital from October 2017 to August 2018 were enrolled and randomly divided into the experimental group(n=42)and the control group(n=45). All patients were given standard AMI treatments, and patients in the experimental group were given Sacubitril/Valsartan(100 mg bid)while those in the control group received Valsartan(80 mg qd). After a follow-up of 12 months, levels of N-terminal pro-brain natriuretic peptide(NT-proBNP), left ventricular end-diastolic diameter(LVDd), left ventricular ejection fraction(LVEF), rates of rehospitalization for heart failure and all-cause mortality were compared between the two groups. Results: Among the 87 patients, 51 patients(58.6%)were male and 36 were female, with an averageage of(67.4±4.0)years.After 12-months of treatment, patients in the experimental group were associated with significantly lower levels of LVDd[(47.86±3.86)mm vs.(50.73±4.39)mm, P<0.05]and NT-proBNP[(793.43±335.43)ng/L vs.(1 068.44±344.46)ng/L, P<0.05]and higher levels of LVEF[(53.74±4.08)% vs.(44.42±7.41)%, P<0.05]than those in the control group.Moreover, the rehospitalization rate for heart failure was markedly higher in the control group than that in the experimental group[15(33.3%)vs.5(11.9%), P<0.05], while the rate of all-cause mortality was similar between the two groups[2(4.8%)vs.3(6.7%), P=0.703]. Conclusions Compared with Valsartan, Sacubitril/Valsartan can reduce the incidence of CHF after AMI, improve left ventricular function, and reduce the rehospitalization rate due to CHF in elderly patients.

Objective To compare the difference of efficacy and adverse effects between TEC-NX regimen (Docetaxel + Epirubicin + Cyclophosphamide sequential Vinorelbine + Capecitabine) with TEC regimen (Docetaxel + Epirubicin + Cyclophosphamide) in the adjuvant chemotherapy of locally advanced breast cancer.Methods A retrospective study was conducted to select 58 patients with locally advanced breast cancer who underwent ≥4 axillary lymph node metastasis from April 2008 to April 2015 at the International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine.All patients were female,average age was 48 years old,rang from 29 to 63 years old.Patients were divided into TEC-NX group (n =23) and TEC group (n =35) according to different treatment methods.TEC-NX group patients received chemotherapy with TEC-NX regimen and TEC group patients received chemotherapy with TEC regimen.The 3-year overall survival rate and 3-year disease-free survival rate were compared between the two groups.The differences in adverse reactions such as myelosuppression,liver dysfunction and fever were compared between the two groups.The Chi-square test was used to compare the count data between the two groups;the survival analysis was performed by Kaplan-Meier method.Results The 3-year overall survival rate was 91.3％ in the TEC-NX group and 91.4％ in the TEC group,and the difference was not statistically significant (P =0.995).The 3-year disease-free survival rate was 73.9％ in the TEC-NX group and 85.7％ in the TEC group,and the difference was not statistically significant (P=0.289).The incidence of grade Ⅲ or Ⅳ myelosuppression in the TEC-NX group was 26.0％,which was significantly lower than that in the TEC group (65.7％),and the difference was statistically significant (P =0.009).The incidence of liver dysfunction was 91.3％ in the TEC-NX group,and there was not statistically significant compared with 93.5％ in the TEC group (P =0.523).The incidence of fever in the TEC-NX group was 17.4％,which was not statistically significant compared with the TEC group (14.3％) (P =0.749).Conclusion In adjuvant chemotherapy for locally advanced breast cancer,the TEC-NX regimen does not improve 3-year overall survival and disease-free survival compared with the TEC regimen,but the TEC-NX regimen significantly reduced the incidence of grade Ⅲ or Ⅳ myelosuppression.

Contrast induced nephropathy (CIN) is acute renal injury following administration of contrast media during angiographic or other medical procedures, which represents as the third cause of hospital-acquired renal failure. CIN is associated with prolonged hospital stay, increased health-care costs, and undesirable clinical outcome. The risk of CIN includes advanced age and diabetes mellitus. With the rapid development of iconography and the wide application of interventional techniques, the patients with CIN are increasing. The preventive measures of CIN include hydration, using appropriate contrast media, stopping nephrotoxic drugs, ischemic preconditioning, renal replacement therapy, and using appropriate drugs. In this paper, the current status and early prevention progress of CIN will be reviewed from three aspects of the high-risk factors, pathogenesis and prevention, aiming to provide guidance for the early prevention of CIN and explore new research directions.

Contrast induced nephropathy (CIN) is acute renal injury following administration of contrast media during angiographic or other medical procedures, which represents as the third cause of hospital-acquired renal failure. CIN is associated with prolonged hospital stay, increased health-care costs, and undesirable clinical outcome. The risk of CIN includes advanced age and diabetes mellitus. With the rapid development of iconography and the wide application of interventional techniques, the patients with CIN are increasing. The preventive measures of CIN include hydration, using appropriate contrast media, stopping nephrotoxic drugs, ischemic preconditioning, renal replacement therapy, and using appropriate drugs. In this paper, the current status and early prevention progress of CIN will be reviewed from three aspects of the high-risk factors, pathogenesis and prevention, aiming to provide guidance for the early prevention of CIN and explore new research directions.
Acute Kidney Injury ; Angiography ; Contrast Media ; Humans ; Ischemic Preconditioning ; Kidney Diseases ; Renal Replacement Therapy ; Risk Factors