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 diagnostic value of peripheral blood trimethylamine N-oxide(TMAO)combined with neutrophil-to-lymphocyte ratio(NLR)in patients with acute ische-mic stroke(AIS).Methods A total of 100 AIS patients were selected as study group,and 100 non-stroke study objects who underwent physical examinations during the same period were selected as con-trol group.Blood samples were collected from all participants,and plasma TMAO levels were meas-ured using high-performance liquid chromatography-tandem mass spectrometry.TMAO levels and NLR were compared between two groups,and Spearman correlation analysis,multivariate logistic regression analysis,and receiver operating characteristic(ROC)curve were applied to evaluate the diagnostic val-ue of TMAO and NLR in AIS.Results Compared with the control group,the AIS group had signifi-cantly higher TMAO levels and NLR(P＜0.05).Spearman correlation analysis indicated that TMAO and NLR were positively correlated with the occurrence of AIS(P＜0.05).Multivariate Logistic re-gression analysis revealed that age,TMAO,NLR,and hypertension were independent influencing fac-tors for the occurrence of AIS(P＜0.05).The ROC curve showed that the optimal cut-off values for TMAO and NLR in predicting AIS were 3.749 μmol/L and 2.210,respectively.The area under the curve for TMAO combined with NLR in predicting AIS was 0.902,which was higher than that of TMAO or NLR alone(0.808 and 0.801,respectively),and the Youden index for combined prediction was greater.Conclusion Peripheral blood TMAO and NLR are positively correlated with the occurrence of AIS,and the combination of TMAO and NLR can significantly improve the diagnostic efficacy of AIS,providing a basis for early clinical identification of AIS.

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 strengthen human genetic resource management in clinical trials.Methods This article analyzes the common problems in the process of reviewing human genetic resources application by the drug clinical trial institute in our hospital,and proposes solutions for solving the problems.Results Common questions are also the key points for future review of human genetic resources applications,including the collection of sample and consistency with clinical trial plan,ethical review and informed consent,intellectual property rights etc.Conclusions Strictly reviewing applications of human genetic resources,as well as strengthen the management of human genetic resources in clinical trials,are not only make traceability of human genetic resources traceable,but also have important significance for the authenticity and scientific validity of trial results.

Objective To study the correlation of wake-up stroke with progressive stroke.Methods Three hundred and twelve patients with acute ischemic stroke,admitted to our hospital from January 2014 to December 2015 were divided into progressive stroke group (n=70) and non-progressive stroke group (n=242).Demographic features,clinical characteristics,and incidence of wake-up stroke were compared between the two groups.The association between wake-up stroke and progressive stroke was analyzed.Results The incidence of wake-up stroke,homocysteine level,and fibrinogen level in progressive stroke group were significantly higher than those in the non-progressive stroke group (40.0％ vs.18.2％,P=0.000;[17.486±16.835] μmol/L vs.[14.321±7.251] μmol/L,P=0.023;[3.539±1.009] g/L vs.[3.134±0.775] g/L,P=0.000).Multivariate Logistic regression analysis showed that wake-up stoke,homocysteine and fibrinogen were the independent predictive factors of progressive stroke (OR=2.978,95％CI:1.623-5.464,P=0.000;OR=1.026,95％CI:1.002-1.052,P=0.035;OR=1.800,95％CI:1.310-2.472,P=0.000).Conclusion Wake-up stoke is a predictive factor of progressive stroke.

OBJECTIVETo observe the clinical effect of acupuncture at Baihui(GV 20) and Shenting(GV 24) combined with rehabilitation for post-stroke cognitive impairment(PSCI).

METHODSFifty patients with PSCI were randomly assigned to an observation group and a control group,25 cases in each one. In the control group,basic treatment and regular rehabilitation were applied. In the observation group,acupuncture at Baihui(GV 20) and Shenting(GV 24) and the same therapies as the control group were used for continuous four weeks,once a day and five times a week. Mini-mental state examination(MMSE) and Montreal cognitive assessment(MoCA) were observed before and after treatment in the two groups.

RESULTSAfter treatment,the scores of MMSE and MoCA were improved apparently(both<0.05),with better results in the observation group(both<0.05).

CONCLUSIONSAcupuncture at Baihui(GV 20) and Shenting(GV 24) combined with basic treatment and regular rehabilitation can obviously improve the cognitive function of PSCI,and the effect is superior to that of basic treatment and regular rehabilitation.

Objective To study the different effects on unilateral middle cerebral artery infarction with standard large trauma craniotomy and frontotemporal craniectomy and decompression treatment.Methods The clinical data of 56 patients with unilateral middle cerebral artery infarction were retrospectively analyzed.They were divided into the two groups according to the different operation methods,and compared the incidence of postoperative complications and GCS score after 1 week,GOS score after 1 month,and ADL score after 6 months and so on.Results The differences were significant between the two groups in incidence of postoperative complications [ incidence of rebleeding after the operation(A group 5 cases,B group 4 cases),showing of brain pools(A group 23 cases,B group 14 cases),lung infection(A group 7 cases,B group 13 cases),gastrointestinal bleeding(A group 8 cases,B group 17 cases),χ2 =0.579,4.703,8.606,7.081] and postoperative GCS score after a week[12 -15points(A group 5 cases,B group 2 cases),9-11points(A group 15 cases,B group 10 cases),5-8points(A group 6 cases,B group 8 cases),3-4points(A group 2 cases,B group 4 cases),death(A group 1 case,B group 3 cases),W value was 599.500,P=0.028] (all P<0.05).There was significant difference in postoperative GOS score and rate of brain tissue bulging after a month [ advantages ( A group 7 cases, B group 4 cases ) , good ( A group 15 cases, B group 8 cases),middle(A group 3 cases,B group 6 cases),poor(A group 2 cases,B group 4 cases),death(A group 1 case,B group 2 cases),encephalocele(A group 9 cases,B group 19 cases),W value was 492.000,P=0.007](all P<0.05).There was no difference in postoperative ADL score half of a year(P>0.05).Conclusion Standard large trauma craniotomy has features as decompression full,low early complication rate,and can improve the short-term efficacy of unilateral middle cerebral artery infarction in patients,and promote recovery.

Objective:To analyse the role of Bcl-6/Blimp-1/IL-21 in pathogenesis of primary Sj?gren′s syndrome(PSS),the relationship between Bcl-6/Blimp-1/IL-21 expression and labial gland biopsy grading.Methods:Immunohistochemical(IHC) method was used to detect the expression of Bcl-6/Blimp-1 in salivary gland between 30 cases pations with PSS in disease group and 11 cases patients with mucous cyst,lower lip trauma in control group,and the serum IL-21 levels between disease group of 40 cases patients with PSS and 30 cases healthy volunteers were measured by enzyme-linked immunosorbent assay( ELISA) ,relations among 15 patients with IL-21 expression levels with labial gland biopsy grading.Results:The expression levels of Bcl-6/Blimp-1/IL-21 in disease group were higher than control group;in disease group,with pathological grades increased,the expression levels of Bcl-6/Blimp-1/IL-21 were also raised.Conclusion:①Bcl-6/Blimp-1/IL-21 may participate in the pathogenesis of PSS;Bcl-6/Blimp-1/IL-21 is associated with infiltration lymphocytes of salivary gland.

Objective To observe the therapeutic effect of consciousness-restoring needling combined with comprehensive rehabilitation training on motor function and the activities of daily living of poststroke patients with hemiplegia. Methods Sixty qualified patients were evenly randomized into observation group and control group. All of the patients were given conventional medicine treatment and conventional rehabilitation training, and the treatment group was given consciousness-restoring needling additionally. The therapeutic effects were compared at the end of first session of treatment for 4 weeks and 12 weeks after the first session of treatment. The Fugl-Meyer motor assessment scale (FMA), modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale ( SS-QQL) were taken as the main evaluation indexes. Results The differences of FMA, MBI and SS-QOL scores were insignificant between the two groups before treatment ( P>0.05). At the end of treatment for 4 weeks, FMA, MBI and SS-QOL scores were increased in the two groups (P<0.05), and the increase was more obvious in the observation group (P<0.05). The results of follow-up till the 12th week showed that FMA, MBI and SS-QOL scores were still higher than the baseline level ( P<0.05). Conclusion Consciousness-restoring needling combined with comprehensive rehabilitation training has better effect on improving motor function and the activities of daily living of poststroke hemiplegia patients than comprehensive rehabilitation training alone.