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 clinical significance of serum B cell activating factor(BAFF)and complement lytic factor Bb in patients with idiopathic membranous nephropathy(IMN),as well as their correlation with the urinary albumin-to-creatinine ratio(UACR).Methods A total of 204 IMN patients were enrolled as the study group,and 100 healthy individuals undergoing physical examinations during the same period served as the control group.Serum levels of BAFF,Bb,and UACR were measured and compared between the two groups.Pearson correlation analysis was performed to assess the associations among serum BAFF,Bb,and UACR.The patients in the study group were followed up for 12 months and stratified into a favorable prognosis group and a poor prognosis group(defined as no remission)based on disease remission status.Demographic and clinical characteristics,as well as serum BAFF and Bb levels,were compared between the two outcome groups.Multivariate logistic regression analysis was conducted to identify independent predictors of poor prognosis in IMN patients.Receiver operating char-acteristic(ROC)curve analysis was employed to evaluate the predictive value of these indicators for poor prognosis.Results The levels of BAFF,Bb,and UACR in the research group were significantly higher than those in the con-trol group(P<0.05).Pearson correlation analysis revealed that both BAFF and Bb were positively correlated with UACR(r=0.716 and 0.543,respectively;P<0.05).After one year of follow-up,a total of 200 patients completed the study,among whom 46 experienced poor prognosis.Based on the follow-up outcomes,patients were categorized into a poor prognosis group(n=46)and a good prognosis group(n=154).The poor prognosis group exhibited significantly higher levels of serum creatinine,24-hour urinary protein,BAFF,and Bb,as well as lower eGFR values,compared to the good prognosis group(P<0.05).Multivariate regression analysis identified 24-hour urinary protein,BAFF,and Bb as independent risk factors for poor prognosis in patients with IMN,whereas eGFR was identified as a protective factor(P<0.05).ROC curve analysis demonstrated that the combined assessment of 24-hour urinary protein,eGFR,BAFF,and Bb yielded a higher AUC value for predicting poor prognosis in IMN patients than any single indicator alone(Z=4.145,3.908,4.308,3.864;P<0.05).Conclusions The serum levels of BAFF and Bb in patients with IMN are significantly elevated and positively correlated with the UACR.The combi-nation of 24-hour urinary protein excretion and eGFR demonstrates high predictive value for poor prognosis in these patients.These findings suggest that BAFF and Bb may serve as potential biomarkers for prognostic assessment in IMN,and the integrated measurement of multiple parameters could provide a more comprehensive clinical basis for disease management.

Objective To investigate the clinical significance of serum B cell activating factor(BAFF)and complement lytic factor Bb in patients with idiopathic membranous nephropathy(IMN),as well as their correlation with the urinary albumin-to-creatinine ratio(UACR).Methods A total of 204 IMN patients were enrolled as the study group,and 100 healthy individuals undergoing physical examinations during the same period served as the control group.Serum levels of BAFF,Bb,and UACR were measured and compared between the two groups.Pearson correlation analysis was performed to assess the associations among serum BAFF,Bb,and UACR.The patients in the study group were followed up for 12 months and stratified into a favorable prognosis group and a poor prognosis group(defined as no remission)based on disease remission status.Demographic and clinical characteristics,as well as serum BAFF and Bb levels,were compared between the two outcome groups.Multivariate logistic regression analysis was conducted to identify independent predictors of poor prognosis in IMN patients.Receiver operating char-acteristic(ROC)curve analysis was employed to evaluate the predictive value of these indicators for poor prognosis.Results The levels of BAFF,Bb,and UACR in the research group were significantly higher than those in the con-trol group(P<0.05).Pearson correlation analysis revealed that both BAFF and Bb were positively correlated with UACR(r=0.716 and 0.543,respectively;P<0.05).After one year of follow-up,a total of 200 patients completed the study,among whom 46 experienced poor prognosis.Based on the follow-up outcomes,patients were categorized into a poor prognosis group(n=46)and a good prognosis group(n=154).The poor prognosis group exhibited significantly higher levels of serum creatinine,24-hour urinary protein,BAFF,and Bb,as well as lower eGFR values,compared to the good prognosis group(P<0.05).Multivariate regression analysis identified 24-hour urinary protein,BAFF,and Bb as independent risk factors for poor prognosis in patients with IMN,whereas eGFR was identified as a protective factor(P<0.05).ROC curve analysis demonstrated that the combined assessment of 24-hour urinary protein,eGFR,BAFF,and Bb yielded a higher AUC value for predicting poor prognosis in IMN patients than any single indicator alone(Z=4.145,3.908,4.308,3.864;P<0.05).Conclusions The serum levels of BAFF and Bb in patients with IMN are significantly elevated and positively correlated with the UACR.The combi-nation of 24-hour urinary protein excretion and eGFR demonstrates high predictive value for poor prognosis in these patients.These findings suggest that BAFF and Bb may serve as potential biomarkers for prognostic assessment in IMN,and the integrated measurement of multiple parameters could provide a more comprehensive clinical basis for disease management.

Objective To observe the effect of pirfenidone on myocardial fibrosis in rats and inves-tigate its underlying mechanism.Methods Twenty-four SD rats were randomly divided into sham-operation group,model group,low-and high-dose pirfenidone groups,with 6 rats in each group.Rat model of myocardial fibrosis was established by injecting isoprenaline into the tail vein,while normal saline was given to the sham operation group.Pirfenidone of 150 and 300 mg/(kg·d)were infused gastrically to the rats of low-and high-dose pirfenidone groups after modeling.Mas-son staining was used to observe the severity of myocardial fibrosis,immunohistochemical assay was employed to detect the expression of Collagen-1,NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome,cysteinyl aspartate-specific protease-1(Caspase-1),and Western blotting was performed to detect the protein levels of Collogen-1 and atrial desmo-plakin D(gasdermin D,GSDMD).Results The model group showed obvious myocardial fibrosis,and elevated expression of Collogen-1,NLRP3,Caspase-1 and GSDMD when compared with the sham operation group(P＜0.05).Low-and high-dose pirfenidone treatment resulted in signifi-cantly reduced myocardial fibrosis and reduced expression of Collogen-1,NLRP3,Caspase-1 and GSDMD[(8.14±1.40)％,(6.56±0.75)％vs(22.15±2.57)％,P＜0.05;0.14±0.03 vs 0.33±0.05,0.42±0.13,P＜0.05;(10.34±1.40)％,(10.33±3.40)％vs(23.22±1.99)％,P＜0.05;(15.67±0.56)％,(17.33±0.78)％vs(22.87±1.92)％,P＜0.05;0.43±0.06,0.46±0.11 vs 0.65±0.03,P＜0.05].Conclusion Pirfenidone inhibits cardiomyocyte pyroptosis and attenuates myocar-dial fibrosis through the NLRP3/Caspase-1/GSDMD signaling axis.

Objective To observe the effect of pirfenidone on myocardial fibrosis in rats and inves-tigate its underlying mechanism.Methods Twenty-four SD rats were randomly divided into sham-operation group,model group,low-and high-dose pirfenidone groups,with 6 rats in each group.Rat model of myocardial fibrosis was established by injecting isoprenaline into the tail vein,while normal saline was given to the sham operation group.Pirfenidone of 150 and 300 mg/(kg·d)were infused gastrically to the rats of low-and high-dose pirfenidone groups after modeling.Mas-son staining was used to observe the severity of myocardial fibrosis,immunohistochemical assay was employed to detect the expression of Collagen-1,NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome,cysteinyl aspartate-specific protease-1(Caspase-1),and Western blotting was performed to detect the protein levels of Collogen-1 and atrial desmo-plakin D(gasdermin D,GSDMD).Results The model group showed obvious myocardial fibrosis,and elevated expression of Collogen-1,NLRP3,Caspase-1 and GSDMD when compared with the sham operation group(P＜0.05).Low-and high-dose pirfenidone treatment resulted in signifi-cantly reduced myocardial fibrosis and reduced expression of Collogen-1,NLRP3,Caspase-1 and GSDMD[(8.14±1.40)％,(6.56±0.75)％vs(22.15±2.57)％,P＜0.05;0.14±0.03 vs 0.33±0.05,0.42±0.13,P＜0.05;(10.34±1.40)％,(10.33±3.40)％vs(23.22±1.99)％,P＜0.05;(15.67±0.56)％,(17.33±0.78)％vs(22.87±1.92)％,P＜0.05;0.43±0.06,0.46±0.11 vs 0.65±0.03,P＜0.05].Conclusion Pirfenidone inhibits cardiomyocyte pyroptosis and attenuates myocar-dial fibrosis through the NLRP3/Caspase-1/GSDMD signaling axis.

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 effects of RNA binding protein 15(RBM15)on the malignant biological behaviors of cervical cancer cells by regulating the Wnt/β-catenin pathway through ATPase family AAA-domain containing 3A(ATAD3A).Methods:TCGA database was used to analyze the expression level of RBM15 mRNA in cervical cancer tissues and its relationship with patient prognosis.32 samples of cervical cancer tissues and adjacent para-cancerous tissues surgically removed in Ganzhou People's Hospital between January and October 2024,as well as cervical cancer cells HeLa,MS-751,C-33A,and SiHa,were collected.The expression levels of RBM15 in cervical cancer tissues and cells were detected by immunohistochemistry and WB assay.m6A modification sites in ATAD3A mRNA were screened by the SRAMP online database.The interaction between RBM15 and ATAD3A mRNA were identified by RNA immunoprecipitation assay,RNA decay assay,and salvage assay.Knockdown or overexpression of RBM15 and ATAD3A in cervical cancer HeLa and SiHa cells were conducted by RNA interference and viral infection.The expressions of mRNA and protein were detected by qPCR and WB methods,while the proliferation,migration,and invasion abilities of cells in each group were assessed by CCK-8 method,scratch assay,and Transwell assay.Results:The positivity rates of RBM15 mRNA and protein in cervical cancer tissues were significantly higher than those in adjacent para-cancerous tissues(both P<0.001).The protein expression levels of RBM15 in cervical cancer cell lines HeLa,MS-751,C-33A,and SiHa were significantly higher than those in normal cervical cell lines Ect1/E6E7(all P<0.001).The 5-year progression free survival rate of the RBM15 mRNA high expression group was lower than that of the low expression group(P<0.001).Compared with that in adjacent para-cancerous tissues,the expression level of ATAD3A was significantly upregulated in cervical cancer tissues(P<0.001).RBM15 mRNA was positively correlated with ATAD3A mRNA(r=0.601,P<0.05).There were highly reliable m6A modification sites at position 501,5 312,12 137 in ATAD3A mRNA.Overexpression of RBM15 in HeLa and SiHa cells led to an increase in ATAD3A mRNA and protein expressions,while knockdown of RBM15 resulted in a decrease in ATAD3A mRNA and protein expression(all P<0.001).RNA immunoprecipitation experiment showed that compared with the IgG group,ATAD3A mRNA was significantly enriched in the immunoprecipitation of RBM15 antibody(both P<0.001).MeRIP-qPCR experiment showed that there was significant m6A methylation enrichment at positions ATAD3A mRNA 501,5 312 and 12 137(all P<0.001).RNA decay experiments showed that knocking down RBM15 in HeLa and SiHa cells could reduce the half-life and stability of ATAD3A mRNA(all P<0.001).Knocking down the expression of RBM15 in HeLa and SiHa cells could significantly inhibit the proliferation,migration,and invasion of cancer cells and significantly reduce the expressions of Wnt/β-catenin pathway related proteins Wnt3,β-catenin,and vimentin,while overexpression of ATAD3A could completely reverse the above inhibiting effects(all P<0.001).Conclusion:RBM15 can modify ATAD3A mRNA and regulate the Wnt/β-catenin pathway through m6A,and thus promote the proliferation,migration and invasion of cervical cancer cells.

Objective To explore the viral pathogen spectrum characteristics of acute intestinal infection in Hanzhong from 2019 to 2022. Methods Fecal samples from patients with acute intestinal infection in the outpatient clinic of 3201 Hospital from January 2019 to December 2022 were collected. Common enteroviruses such as enterovirus 71 (EV-A71), coxsackievirus 16 (CV-A16), CV-A10, CV-A6, CV-A2, CV-A4, and CV-B3 were detected and analyzed by real-time fluorescence quantitative PCR. Results A total of 5 194 fecal samples were collected, and the positive rate of nucleic acid detection was 23.95%. In terms of the enteroviruses, the highest detection rate was 9.82% for EV-A71, followed by 4.58% for CV-A16 and 3.37% for CV-A6. The positive detection rate of common enteroviruses showed statistical difference among different age groups (P<0.05), with the highest detection rate of 41.49% in 0-4 years old group. There was no significant difference in the positive virus detection rate between different genders (P>0.05). EV-A71 infection showed no seasonal characteristics, whereas the detection of CV-A16 and CV-A6 infections was concentrated in summer and autumn. There were 106 cases of mixed infection, and the prevalence rate was 2.04%, with EV-A71 and CV-A6 mixed infections accounting for the majority of cases. Conclusion The main pathogens of acute intestinal infections in the Hanzhong area from 2019 to 2022 are EV-A71, CV-A16, and CV-A6. It is necessary to strengthen the monitoring of acute intestinal infections in children aged 4 years and below.

More than 70%of tumor patients require radiotherapy.Medical electron linear accelerators are important high-end radiotherapy equipment for tumor radiotherapy.With the application of artificial intelligence technology in medical electron linear accelerator,radiotherapy has evolved from ordinary radiotherapy to today's intelligent radiotherapy.This study introduces the development history,working principles and system composition of medical electron linear accelerators.It outlines the key technologies for improving the performance of medical linear electron accelerators,including beam control,multi-leaf collimator,guiding technology and dose evaluation.It also looks forward to the development trend of major radiotherapy technologies,such as biological guided radiotherapy,FLASH radiotherapy and intelligent radiotherapy,which provides references for the development of medical electron linear accelerators.