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 explore the effectiveness of digital management platform led by outpatient specialist nurses among patients with type 2 diabetes in outpatient settings.Methods:From March 2024 to March 2025, adult patients with type 2 diabetes who visited the Endocrinology Clinic at Peking Union Medical College Hospital were selected using convenience sampling. Patients were randomly assigned to the control group and intervention group using the random number table method. Patients in control group received routine education on type 2 diabetes during their clinic visits after enrollment. Intervention group was managed by nurses through a digital management platform, establishing long-term connections with patients. Based on the platform, nurses regularly provided patients with knowledge updates, promptly responded to patient inquiries, reviewed daily dietary records, monitored blood glucose data, conducted weekly telephone follow-ups, and scheduled regular clinic visits to precisely intervene in patients' lifestyles. The glycated hemoglobin (HbA1c) and self-management behavior scores were compared between two groups of patients before and after three months of intervention.Results:A total of 46 patients were enrolled and completed the 3-month follow-up, including 25 in control group and 21 in intervention group. There were no statistically significant differences in HbA1c or self-management behavior scores between the two groups of patients before intervention ( P>0.05). At three months of intervention, the HbA1c reduction in intervention group was greater than that in control group, with a statistically significant difference ( P<0.05). There was no statistically significant difference in Summary of Diabetes Self-Care Activities Scale scores between the two groups ( P>0.05). The difference in changes in diabetic foot self-screening scores between intervention group and control group was statistically significant ( P<0.05) . Conclusions:Specialist nurse-led precision health care management utilizing digital platforms can improve HbA1c and enhance self-management behaviors for diabetic foot in patients with type 2 diabetes, which is expected to be promoted and applied in the outpatient management of diabetes patients.

Objective To investigate the correlation between the expression of lectin galactoside binding soluble-3 binding protein(LGALS3BP),GTP enzyme activating protein SH3 functional region binding protein 1(G3BP1)and Wnt/β-catenin pathway genes in endometrial cancer(EC)tissues and its clinical prognostic significance.Methods 138 patients with EC treated in Cangzhou Central Hospital from February 2016 to February 2019 were selected.qRT-PCR was used to detect the expression of LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes Wnt5a mRNA,β-catenin mRNA and matrix metalloproteinase-9(MMP-9)mRNA in cancer and adjacent tissues.The expression of LGALS3BP protein and G3BP1 protein in cancer and adjacent tissues was detected by immunohistochemistry.Pearson correlation analysis was used to analyze the correlation between LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes.Kaplan-Meier curve was used to analyze the effect of LGALS3BP mRNA and G3BP1 mRNA on the survival and prognosis of EC patients.COX regression model was used to analyze the factors affecting the prognosis of EC patients.Results The expression of LGALS3BP mRNA(3.01±0.34),G3BP1 mRNA(2.87±0.33),Wnt5a mRNA(2.29±0.26),β-catenin mRNA(3.25±0.41)and MMP-9 mRNA(2.68±0.36)in EC cancer tissues were higher than those in adjacent tissues(1.10±0.23,1.06±0.24,0.84±0.17,0.88±0.26,0.69±0.17),and the differences were statistically significant(t=52.109～58.719,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in EC was positively correlated with the expression of Wnt5a mRNA,β-catenin mRNA and MMP-9 mRNA(r=0.675～0.781,all P<0.001).The expression of LGALS3BP protein(3.54±0.47 vs 0.51±0.16)and G3BP1 protein(2.84±0.44 vs 0.42±0.13)in EC cancer tissues were higher than that in adjacent tissues,and the differences were statistically significant(t=71.692,61.962,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in cancer tissues of EC patients with FIGO stage Ⅲ and lymph node metastasis were higher than that of FIGO stage Ⅰ～Ⅱ and no lymph node metastasis,and the differences were statistically significant(t=40.279～557.671,all P<0.001).The 5-year survival rate of LGALS3BP mRNA high expression group was 58.82%(40/68),which was lower than that of low expression group 94.29%(66/70),and the difference was statistically significant(Log-rank χ2=24.970,P<0.001).The 5-year survival rate of G3BP1 mRNA high expression group was 62.12%(41/66),which was lower than that of low expression group 90.28%(65/72),and the difference was statistically significant(Log-rank χ2=15.960,P<0.001).FIGO stage Ⅲ,lymph node metastasis,high expression of LGALS3BP mRNA and high expression of G3BP1 mRNA were risk factors for poor prognosis of EC patients(Wald χ2=7.847～12.054,all P<0.001).Conclusion The expression of LGALS3BP and G3BP1 mRNA is elevated in EC,both of which are associated with Wnt/β-catenin pathway genes,promoting the malignant progression of EC tumors,and are new tumor markers for evaluating the prognosis of EC patients.

Chronic thromboembolic pulmonary hypertension(CTEPH)is a severe form of pulmonary hypertension(PH),and is classified as the fourth major category of pulmonary arterial hypertension.CTEPH is primarily caused by chronic thrombosis,leading to the obstruction of blood flow in the pulmonary arteries and result ing in a sustained increase in pulmonary artery pressure.The unclear pathogenesis of CTEPH,however,means that its early diagnosis is challenging,treatment options are limited,and prognosis assessment is often inaccurate.In-depth research into these mechanisms will thus improve our understanding of the pathophysiological processes of CTEPH,and also provide a theoretical basis for developing new therapeutic strategies.This review focuses on the current method of establishing CTEPH rat models and their advantages and disadvantages,offering researchers a reference for selecting and constructing CTEPH rat models.

Objective To study the economic burden caused by healthcare-associated infection(HAI)in patients with severe acute pancreatitis(SAP),and provide theoretical basis for formulating HAI prevention and control measures.Methods Patients with SAP discharged from a tertiary first-class hospital in Jiangxi Province from July 1,2023 to June 30,2024 were selected as the study subjects.Information including demographic characteristics,clinical data,and hospitalization expense were collected.Patients were divided into a HAI group and a non-HAI group according to HAI occurrence.A propensity score matching(PSM)method was used to conduct a 1∶2 ma-tching,and differences in the length of hospital stay and hospitalization expense between the two groups of patients after PSM were compared.Results A total of 709 patients were included in the analysis,out of which 65 cases ex-perienced HAI,with a HAI incidence of 9.17％.After PSM,all 65 patients in the HAI group were successfully matched.The length of hospital stay,total hospitalization expense,expenses of medication and hygiene product of patients in the HAI group were all higher than those in the non-HAI group,and differences were all statistically sig-nificant(all P＜0.001).Patients who experienced≥2 episodes of HAI had a higher economic burden than those who experienced only once(P＜0.05).HAI of bloodstream,abdomen,digestive system,and respiratory system significantly increased the economic burden of patients(all P＜0.05).Conclusion HAI in SAP patients can extend the length of hospital stay and increase economic burden of patients.Targeted infection prevention and control mea-sures should be formulated to reduce the incidence of HAI and save medical resources.

Objective To evaluate the potential of the BIBP-H fluorescent probe in the detection of the oxidative stress levels after cerebral ischemia-reperfusion(CIRI).Methods In vitro,the potential of BIBP-H probe was in detection of oxidative stress was first assessed with fluorescence imaging in rat neuroblastoma(B104)cells after L-glutamic acid stimulation.And then,the effects of edaravone and dexborneol(EDA)and glutathione(GSH)pretreatment on the fluorescence intensity were evaluated.Later,a totally of 28 male C57BL/6 mice were randomly assigned into four groups:transient middle cerebral artery occlusion(tMCAO)group,EDA+tMCAO group,GSH+tMCAO group,and sham group.After 1.5 h ischemia and 12 h reperfusion,the mice were treated with BIBP-H via tail vein injection.In vivo,ex vivo,and tissue fluorescence imaging were utilized to evaluate the probe's cerebral ischemia-reperfusion injury(CIRI).Results ① BIBP-H probe did not exhibit fluorescence signals in cultured B104 cells,but showed red fluorescence in B104 cells treated with L-glutamic acid.The signals significantly decreased when pretreated with EDA or GSH.② Both the sham-operated mice intravenously injected with the BIBP-H probe and the tMCAO mice without injection of the probe showed negative results in in vivo fluorescence imaging.③ tMCAO mice treated with BIBP-H exhibited red fluorescence signals in the ischemic hemisphere in vivo,with significantly reduced fluorescence intensity after EDA or GSH infusion during reperfusion ④ The fluorescence area examined with BIBP-H was consistent the cerebral infarction area detected with triphenyltertrazolium.Conclusions The BIBP-H probe effectively monitored oxidative stress levels both in vivo and in vitro,demonstrating its potential in CIRI detection.

BACKGROUND:The relationship between rheumatoid arthritis and coronary atherosclerosis has received extensive attention.Inflammation is related to rheumatoid arthritis and coronary atherosclerosis,indicating that there may be a common pathophysiological pathway between the two diseases.However,observational studies have not yet clarified the causal relationship.OBJECTIVE:To explore whether there is a causal relationship between rheumatoid arthritis and coronary atherosclerosis,as well as the potential causal relationship with 1 400 serum metabolites and 91 inflammatory factors through a Mendelian randomization analysis.METHODS:Coronary atherosclerosis data are from Finngen database,rheumatoid arthritis data are from IEU OpenGWAS database,serum metabolites data are from Canadian Longitudinal Study on Aging,Augsburg Cooperative Health Research and British Twin Project Research,and data of 91 inflammatory proteins are from research published in Nature Immunology in 2023.Mendelian randomization analysis was performed using data from genome-wide association studies,and causal effects were evaluated using inverse variance weighting,MR-Egger regression,weighted median,weighted model,and simple model methods,with inverse variance weighting being the primary analysis method.To enhance robustness,Cochran's Q-test MR-Egger intercept was used for sensitivity analysis.RESULTS AND CONCLUSION:(1)Inverse variance weighting results showed that rheumatoid arthritis was positively correlated with the increased relative risk of coronary atherosclerosis(odds ratio=1.002,95％confidence interval=1.001-1.003,P=0.003).There was no reverse causal relationship between coronary atherosclerosis and rheumatoid arthritis.In addition,96 serum metabolites and 9 inflammatory factors were found to have causal relationships with coronary atherosclerosis.There was a causal relationship between 51 serum metabolites and 7 inflammatory factors and rheumatoid arthritis.(2)This study provided epidemiological evidence between rheumatoid arthritis and coronary atherosclerosis,and emphasized the potential role of serum metabolites and inflammatory factors in the pathogenesis of these diseases.These findings may contribute to the development of new treatment strategies.Due to the limited inclusion of data from Asian populations,most contemporary studies used international databases and European population analyses.By collecting and analyzing the health data of European populations,it is conducive to a better understanding of the effects and potential role of Chinese medicine in Europe,and to further promote the practice of modern integration of Western and Chinese medicine.Meanwhile,through the comparative study with the European databases,it is possible to reveal the genetic differences and susceptibility to diseases among different populations,providing more dimensions and perspectives for global health research.

Objective To investigate the correlation between the expression of lectin galactoside binding soluble-3 binding protein(LGALS3BP),GTP enzyme activating protein SH3 functional region binding protein 1(G3BP1)and Wnt/β-catenin pathway genes in endometrial cancer(EC)tissues and its clinical prognostic significance.Methods 138 patients with EC treated in Cangzhou Central Hospital from February 2016 to February 2019 were selected.qRT-PCR was used to detect the expression of LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes Wnt5a mRNA,β-catenin mRNA and matrix metalloproteinase-9(MMP-9)mRNA in cancer and adjacent tissues.The expression of LGALS3BP protein and G3BP1 protein in cancer and adjacent tissues was detected by immunohistochemistry.Pearson correlation analysis was used to analyze the correlation between LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes.Kaplan-Meier curve was used to analyze the effect of LGALS3BP mRNA and G3BP1 mRNA on the survival and prognosis of EC patients.COX regression model was used to analyze the factors affecting the prognosis of EC patients.Results The expression of LGALS3BP mRNA(3.01±0.34),G3BP1 mRNA(2.87±0.33),Wnt5a mRNA(2.29±0.26),β-catenin mRNA(3.25±0.41)and MMP-9 mRNA(2.68±0.36)in EC cancer tissues were higher than those in adjacent tissues(1.10±0.23,1.06±0.24,0.84±0.17,0.88±0.26,0.69±0.17),and the differences were statistically significant(t=52.109～58.719,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in EC was positively correlated with the expression of Wnt5a mRNA,β-catenin mRNA and MMP-9 mRNA(r=0.675～0.781,all P<0.001).The expression of LGALS3BP protein(3.54±0.47 vs 0.51±0.16)and G3BP1 protein(2.84±0.44 vs 0.42±0.13)in EC cancer tissues were higher than that in adjacent tissues,and the differences were statistically significant(t=71.692,61.962,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in cancer tissues of EC patients with FIGO stage Ⅲ and lymph node metastasis were higher than that of FIGO stage Ⅰ～Ⅱ and no lymph node metastasis,and the differences were statistically significant(t=40.279～557.671,all P<0.001).The 5-year survival rate of LGALS3BP mRNA high expression group was 58.82%(40/68),which was lower than that of low expression group 94.29%(66/70),and the difference was statistically significant(Log-rank χ2=24.970,P<0.001).The 5-year survival rate of G3BP1 mRNA high expression group was 62.12%(41/66),which was lower than that of low expression group 90.28%(65/72),and the difference was statistically significant(Log-rank χ2=15.960,P<0.001).FIGO stage Ⅲ,lymph node metastasis,high expression of LGALS3BP mRNA and high expression of G3BP1 mRNA were risk factors for poor prognosis of EC patients(Wald χ2=7.847～12.054,all P<0.001).Conclusion The expression of LGALS3BP and G3BP1 mRNA is elevated in EC,both of which are associated with Wnt/β-catenin pathway genes,promoting the malignant progression of EC tumors,and are new tumor markers for evaluating the prognosis of EC patients.

Objective:To investigate the effectiveness of combined teaching method integrating case-based teaching method(CBL),problem-based teaching method(PBL),and team-based teaching method(TBL)in clinical nursing teaching in pediatric intensive care unit(PICU).Methods:A total of 60 nursing students who trained in our PICU from Jan 2021 to Jun 2022 were selected as the control group,and 60 nursing students who trained in our PICU from Jul 2022 to Jun 2024 were selected as the research group.The control group received conventional nursing teaching mode,while the research group received combined teaching mode of CBL,PBL,and TBL.The scores of academic performance,logical thinking ability,self-learning ability,and clinical nursing comprehensive ability between the two groups were compared.Result:The scores of theoretical knowledge,operational skills,post-teaching Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)scale,self-directed learning readiness scale for nursing,and Mini-clinical evaluation exercise scale(Mini-CEX)in the research group were higher than those in the control group(P＜0.05).Conclusion:The combined teaching method of CBL,PBL,and TBL can effectively improve clinical nursing teaching results and comprehensive abilities of nursing students.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome