Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

Bladder cancer is one of the common genitourinary malignancies. Since the discovery of intravesical Bacillus Calmette-Guerin (BCG) in the 1970s for non-muscle invasive bladder cancer, there have not been any major breakthrough drugs especially for locally advanced and metastatic bladder cancer. Recently, the immunotherapy for bladder cancer has made great breakthrough. Immune-checkpoint inhibitors targeting the programmed death 1 (PD-1), programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) pathways have shown significant long-term responses and tolerable safety profiles for locally advanced and metastatic bladder cancer. Inhibitors targeting PD-1, PD-L1 and CTLA-4 are mainly used to restore T cell activity by blocking negative regulation signal, and to enhance the anti-tumor activities of T cells. Other immunotherapies including chimeric antigen receptor T-cell (CAR-T) therapy also have great prospects. In this review, the effect of immunotherapeutic agents and the mechanisms in the treatment of bladder cancer are summarized.

The global prevalence of overweight and obesity has increased dramatically over the past decades. It has been verified that overweight and obesity have been associated with heart disease and type 2 diabetes, as well as the development and prognosis of cancer (such as breast cancer, renal cancer, and endometrium cancer). Adipose tissues surrounding tumor contributes to tumor growth and prognosis through their interactions with malignant cells, secretion of associated molecules (e.g. adipocytokines, proinflammatory cytokines, proangiogenic factors and extracellular matrix constituents) and acting as an energy reservoir for cancer cells. This paper reviews the advances in mechanism of excess body weight and obesity contributing to cancer development and its impact on cancer growth and prognosis.

Objective To observe the clinical efficacy of electroacupuncture at cervical Jiaji (EX-B2) points plus behavioral intervention in treating cervical spondylosis. Method The cervical spondylosis patients were randomized into two groups at a ratio of 3:1, 90 cases in the electroacupuncture group and 30 cases in the medication group. The patients who received electroacupuncture were also given cupping and behavioral intervention (raising head for 1 min every 20-30 min and correcting sleep habits). The clinical efficacy was evaluated according to the symptoms and body signs assessment scale. Result Respectively after 4-week, 8-week, 4-month and 6-month treatments, the clinical control rate, markedly control rate and total effective rate in the electroacupuncture group were significantly higher than that in the medication group. Conclusion Electroacupuncture at Jiaji points plus behavioral intervention is an effective solution to prevent and treat cervical spondylosis.

Objective To investigate the molecular mechanisms of glial cell derived neurotrophic factor in promoting proliferation of spermatogonial stem cell.Methods RNAi expression vectors,targeted at GDNF,were constructed and transfected into SSCs from 5 to 7 days old mice.The SSCs with highest effectiveness of GDNF interfere was set as study group.And the SSCs without GDNF interfere was considered as control group.The ELISA method was used to compare the proliferative rate between study group and control group.Flow cytometry,RT-PCR were used to detect the expression of GDNF,RTKs,Fyn and FAK's mRNA,and the apoptosis of SSCs.Results From 1 to 4 days after transinfection,the absorbable A value in study group was 0.45 ± 0.02,0.68 ± 0.03,1.12 ± 0.03,2.24 ± 0.04,respectively.Meanwhile,the same item in control group was 0.46 ± 0.03、0.73 ± 0.02、1.32 ± 0.05、1.15 ± 0.06,respectively (P ＜ 0.05).There were significant different between experiment groups (25.43 ± 1.91) ％ and control group (5.61 ± 0.16)％ in the apoptosis rates of SSCs (P ＜ 0.05).Significant differences were noted between experimental group and control group(P ＜ 0.05).The mRNA expression rates of GDNF was (12.32 ± 1.22) ％ in study group and (54.25 ± 1.34)％ in control group (P ＜0.01).The mRNA expression rates of RTKs and Fyn and FAK in study group and control group were (16.24 ± 1.35)％ vs (45.35 ± 1.37)％,(18.32 ±1.34)％ vs (38.37 ± 1.55)％,(20.04 ± 1.65)％ vs (43.27 ± 1.28)％,respectively (P ＜0.05).Conclusions The glial cell line derived neurotrophic factor was important in course of SSCs' proliferation,which may up-regulating the expression of RTKs,Fyn and FAK.

OBJECTIVETo evaluate the clinical results and the value of the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation for the treatment of ossifying thoracic disc herniation.

METHODSThirty nine cases of ossifying thoracic disc herniation who accepted the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation were included in this study. There were 21 male and 18 female patients. The age ranged from 33 to 69 years, with an average of 53 years. The course of disease ranged from 1 month to 18 months, with an average of 6.5 months. The lesion locations were T7-8 for 1 case, T8-9 for 4 cases, T9-10 for 9 cases, T10-11 for 7 cases, T11-12 for 10 cases, T12-L1 for 6 cases, and both T11-12 and T12-L1 for 2 cases. The clinical results were evaluated by Otani scored system.

RESULTSThe operative time was from 2.5 to 5.0 hours, with average of 3.3 hours. The blood loss was from 400 to 2 000 ml, with average of 850 ml. All patients were successfully operated without neurological symptoms aggravation and accidents. The followed-up period was 24 to 60 months, mean 40.5 months. According to Otani scored system, there were excellent results in 16 cases and good results in 18 cases. The clinical satisfaction rate was 87.2%. All obtained bony fusion without instrument failure.

CONCLUSIONPosterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation is a safe and effective surgical procedure for the treatment of ossifying thoracic disc herniation.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; Treatment Outcome

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

Background and purpose: The increased of specific expression of prostate cancer antigen 3 (PCA3), as one of long non-coding RNA, has been observed in prostate cancer, indicating that PCA3 may contribute to the development of prostate cancer. To further study its roles in prostate cancer, we construct a lentivirus expression vector carrying the whole PCA3. Methods: PCA3 was amplified from prostate cancer cell line LNCaP by reverse transcriptase polymerase chain reaction (RT-PCR). After the sequence was proved to be correct, we recombined the pCDH-CMV-MCS-EF1-copGFP-PCA3. After transformation into E.coli cells, the candidate clones were identified by PCR amplifying, restricting enzyme digestion analysis and DNA sequencing, and the viral titer was determined. Results: Through the Blast analysis software, we compared the results of PCA3 sequence amplified by PCR with GeneBank sequence, ifnding that the homology is 99.8%. The lentivirus vector was constructed successfully, and the virus in the supernatant reached a titer of 2*108. Conclusion: The successful construction of the lentivirus vector encoding PCA3 not only lays the foundation for the further research into the effect of PCA3 gene on the prostate cancer but also provides a new therapy for advanced prostate cancer.