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.

AIM:To exploring the mechanism of Xin Mai Jia(XMJ)in inhibiting hypertensive cardiac hypertrophy through network pharmacology and animal experiments.METHODS:Retrieving the ac-tive ingredients and target points of XMJ by search-ing the TCMSP database and related literature re-ports;using the Gene Cards,OMIM,and Drug Bank databases to screen targets for hypertensive cardi-ac hypertrophy;constructing a network of tradi-tional Chinese medicine-active ingredients-poten-tial targets and a protein-protein interaction(PPI)network;using DAVID software for target gene on-tology(GO)functional enrichment analysis and Kyo-to Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis;using Auto Dock soft-ware for molecular docking.A spontaneously hy-pertensive rat(SHR)model was established,and hematoxylin-eosin(HE)staining was used to detect the morphology of cardiac tissue and cellular hy-pertrophy,Masson staining was used to detect col-lagen deposition in cardiac tissue,and Western blot to detect the expression of heat shock protein(HSP90AA1),mammalian target of rapamycin(mTOR),peroxisome proliferator-activated receptor y(PPARG),and tumor necrosis factor(TNF-α)in car-diac tissue.RESULTS:A total of 56 potential active ingredients were identified in XMJ,and 5,492 tar-gets related to hypertensive cardiac hypertrophy were obtained.The targets in the core network were ranked according to their Degree values,and four main targets were selected:HSP90AA1,mTOR,PPARG,and TNF-α.The results of HE staining showed that compared with the normal group,the average area of cardiomyocytes in the SHR group increased significantly(P＜0.05),while there was no significant change in the XMJ group.The hypertro-phy in the SHR+XMJ group was significantly alleviat-ed(P＜0.05).The results of Masson staining showed that compared with the normal group,the levels of interstitial fibrosis and perivascular fibrosis in the SHR group rats increased significantly(P＜0.01),and XMJ could significantly reduce the fibrosis levels in the SHR group rats(P＜0.01).The results of Western blot showed that compared with the normal group rats,the expression of HSP90AA1 and PPARG in the myocardial tissue of SHR group rats was downregu-lated,mTOR phosphorylation was downregulated,and TNF-α was significantly upregulated(P＜0.01).In the SHR+XMJ group,the expression of HSP90AA1,PPARG,and TNF-α in the myocardial tis-sue of rats returned to normal levels,and mTOR phosphorylation returned to normal levels.In the XMJ group,there were no significant changes in the above indicators compared with the normal group rats.CONCLUSION:The mechanism underly-ing the inhibitory effect of XMJ on myocardial cell hypertrophy in hypertension involves a comprehen-sive action through multiple components,multiple targets,and multiple pathways.

AIM:To exploring the mechanism of Xin Mai Jia(XMJ)in inhibiting hypertensive cardiac hypertrophy through network pharmacology and animal experiments.METHODS:Retrieving the ac-tive ingredients and target points of XMJ by search-ing the TCMSP database and related literature re-ports;using the Gene Cards,OMIM,and Drug Bank databases to screen targets for hypertensive cardi-ac hypertrophy;constructing a network of tradi-tional Chinese medicine-active ingredients-poten-tial targets and a protein-protein interaction(PPI)network;using DAVID software for target gene on-tology(GO)functional enrichment analysis and Kyo-to Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis;using Auto Dock soft-ware for molecular docking.A spontaneously hy-pertensive rat(SHR)model was established,and hematoxylin-eosin(HE)staining was used to detect the morphology of cardiac tissue and cellular hy-pertrophy,Masson staining was used to detect col-lagen deposition in cardiac tissue,and Western blot to detect the expression of heat shock protein(HSP90AA1),mammalian target of rapamycin(mTOR),peroxisome proliferator-activated receptor y(PPARG),and tumor necrosis factor(TNF-α)in car-diac tissue.RESULTS:A total of 56 potential active ingredients were identified in XMJ,and 5,492 tar-gets related to hypertensive cardiac hypertrophy were obtained.The targets in the core network were ranked according to their Degree values,and four main targets were selected:HSP90AA1,mTOR,PPARG,and TNF-α.The results of HE staining showed that compared with the normal group,the average area of cardiomyocytes in the SHR group increased significantly(P＜0.05),while there was no significant change in the XMJ group.The hypertro-phy in the SHR+XMJ group was significantly alleviat-ed(P＜0.05).The results of Masson staining showed that compared with the normal group,the levels of interstitial fibrosis and perivascular fibrosis in the SHR group rats increased significantly(P＜0.01),and XMJ could significantly reduce the fibrosis levels in the SHR group rats(P＜0.01).The results of Western blot showed that compared with the normal group rats,the expression of HSP90AA1 and PPARG in the myocardial tissue of SHR group rats was downregu-lated,mTOR phosphorylation was downregulated,and TNF-α was significantly upregulated(P＜0.01).In the SHR+XMJ group,the expression of HSP90AA1,PPARG,and TNF-α in the myocardial tis-sue of rats returned to normal levels,and mTOR phosphorylation returned to normal levels.In the XMJ group,there were no significant changes in the above indicators compared with the normal group rats.CONCLUSION:The mechanism underly-ing the inhibitory effect of XMJ on myocardial cell hypertrophy in hypertension involves a comprehen-sive action through multiple components,multiple targets,and multiple pathways.

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.

An in-depth understanding of the mechanism of lower extremity muscle coordination during walking is the key to improving the efficacy of gait rehabilitation in patients with neuromuscular dysfunction. This paper investigates the effect of changes in walking speed on lower extremity muscle synergy patterns and muscle functional networks. Eight healthy subjects were recruited to perform walking tasks on a treadmill at three different speeds, and the surface electromyographic signals (sEMG) of eight muscles of the right lower limb were collected synchronously. The non-negative matrix factorization (NNMF) method was used to extract muscle synergy patterns, the mutual information (MI) method was used to construct the alpha frequency band (8-13 Hz), beta frequency band (14-30 Hz) and gamma frequency band (31-60 Hz) muscle functional network, and complex network analysis methods were introduced to quantify the differences between different networks. Muscle synergy analysis extracted 5 muscle synergy patterns, and changes in walking speed did not change the number of muscle synergy, but resulted in changes in muscle weights. Muscle network analysis found that at the same speed, high-frequency bands have lower global efficiency and clustering coefficients. As walking speed increased, the strength of connections between local muscles also increased. The results show that there are different muscle synergy patterns and muscle function networks in different walking speeds. This study provides a new perspective for exploring the mechanism of muscle coordination at different walking speeds, and is expected to provide theoretical support for the evaluation of gait function in patients with neuromuscular dysfunction.
Humans ; Walking Speed ; Muscle, Skeletal/physiology* ; Electromyography ; Gait/physiology* ; Walking/physiology*

OBJECTIVES: Cardiac hypertrophy and fibrosis are major pathological manifestations observed in left ventricular remodeling induced by angiotensin II (AngII). Low-intensity pulsed ultrasound (LIPUS) has been reported to ameliorate cardiac dysfunction and myocardial fibrosis in myocardial infarction (MI) through mechano-transduction and its downstream pathways. In this study, we aimed to investigate whether LIPUS could exert a protective effect by ameliorating AngII-induced cardiac hypertrophy and fibrosis and if so, to further elucidate the underlying molecular mechanisms. METHODS: We used AngII to mimic animal and cell culture models of cardiac hypertrophy and fibrosis. LIPUS irradiation was applied in vivo for 20 min every 2 d from one week before mini-pump implantation to four weeks after mini-pump implantation, and in vitro for 20 min on each of two occasions 6 h apart. Cardiac hypertrophy and fibrosis levels were then evaluated by echocardiographic, histopathological, and molecular biological methods. RESULTS: Our results showed that LIPUS could ameliorate left ventricular remodeling in vivo and cardiac fibrosis in vitro by reducing AngII-induced release of inflammatory cytokines, but the protective effects on cardiac hypertrophy were limited in vitro. Given that LIPUS increased the expression of caveolin-1 in response to mechanical stimulation, we inhibited caveolin-1 activity with pyrazolopyrimidine 2 (pp2) in vivo and in vitro. LIPUS-induced downregulation of inflammation was reversed and the anti-fibrotic effects of LIPUS were absent. CONCLUSIONS These results indicated that LIPUS could ameliorate AngII-induced cardiac fibrosis by alleviating inflammation via a caveolin-1-dependent pathway, providing new insights for the development of novel therapeutic apparatus in clinical practice.

Objective:to review the clinical features, diagnosis and treatment of spinal Rosai-Dorfman disease(RDD).Methods:we conducted a systemic review and collected the cases reported from 2010. The key words were Rosai-Dorfman disease, spine/central nervous system. We screened both English and Chinese database. There were 43 reports finally included in the study, containing 52 cases. We distracted the information of interest and, subsequently, analyzed the harvested data using specific statistical software packages. The study focused on the summary and description of the clinical features, diagnosis and treatment and prognosis of spinal RDD.Results:The included articles reported 52 cases. The average age was 32.1±17.1 years (ranging from 6 to 76 years old). The ratio of male to female was 1.9/1. The median follow-up period was 19.9 months. The initial symptoms of 41 patients (78.8%) were spinal lesion-related. The cases with painless lymph nodes enlargement, other organ lesions and abnormal lab tests were 11.5%, 36.5% and 23.1%, respectively. The frequent infringed segments were cervical (43.1%) and thoracic (39.2%) spine. 53.2% lesions were dura-based, while 17.0% and 10.6% for bone and cord, respectively. Surgery was the mainstream of the treatment armamentarium, composing 83.7% cases, among which 46.3% underwent total resection. Cases only treated with radiotherapy, chemotherapy and steroids were 10.2%. Very Few cases remitted spontaneously (2.0%). The risk of recurrence and occurrence at other vertebral levels was 22.0%.Conclusion:It is rare for spinal involvement of RDD. This entity has no pathognomonic clinical and imaging features. RDD has a tendency of multi-organ involvement and recurrence. Surgery remains the mainstay of the treatment, but the efficacy of other adjuvant therapies is not sure. A wait and watch strategy is employed for asymptomatic patients.

The ongoing pandemic of Coronavirus disease 19 (COVID-19) is caused by a newly discovered β Coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How long the adaptive immunity triggered by SARS-CoV-2 can last is of critical clinical relevance in assessing the probability of second infection and efficacy of vaccination. Here we examined, using ELISA, the IgG antibodies in serum specimens collected from 17 COVID-19 patients at 6-7 months after diagnosis and the results were compared to those from cases investigated 2 weeks to 2 months post-infection. All samples were positive for IgGs against the S- and N-proteins of SARS-CoV-2. Notably, 14 samples available at 6-7 months post-infection all showed significant neutralizing activities in a pseudovirus assay, with no difference in blocking the cell-entry of the 614D and 614G variants of SARS-CoV-2. Furthermore, in 10 blood samples from cases at 6-7 months post-infection used for memory T-cell tests, we found that interferon γ-producing CD4
Adaptive Immunity/physiology* ; Adult ; Aged ; Antibodies, Neutralizing/blood* ; COVID-19/immunology* ; Cohort Studies ; Female ; Humans ; Immunoglobulin G/blood* ; Male ; Middle Aged ; SARS-CoV-2/immunology* ; T-Lymphocytes/physiology* ; Time Factors ; Viral Proteins/immunology*

Objective: To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients. Methods: The retrospective and descriptive study was conducted. The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected. There were 24 males and 28 females, aged (43±9)years, with the range of 23-62 years. All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass. Observation indicators: (1) surgical and postoperative conditions; (2) changes in anthropometric indices; (3) follow-up. Follow-up using outpatient examination was performed to detect complications of patients at 1, 3, 6, 12 months after surgery up to February 2013. Measurement data with normal distribution were represented as Mean±SD, repeated measurement data were analyzed using repeated ANOVA. Count data were represented as absolute numbers. Results: (1) Surgical and postoperative conditions: all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully, without conversion to open surgery. The volume of intraoperative blood loss, operation time, and duration of hospital stay were (25±11)mL, (78±14)minutes, and (11±2)days. (2) Changes in anthropometric indices: the body mass index (BMI), fat mass, free fat mass, total abdominal fat volume (TAFV), total subcutaneous fat volume (TSFV), and total visceral fat volume (TVFV) of all the 52 patients were (31.8±1.8)kg/m², (39.4±4.1)kg, (50.2±6.0)kg, (11 703±3 899)cm³, (7 418±2 969)cm³, and (4 314±1 692)cm³ before surgery, (28.5±1.4)kg/m², (33.0±1.1)kg, (49.7±4.6)kg, (11 016±3 713)cm³, (7 044±2 970)cm³, (3 969±1 443)cm³ at 3 months after surgery, (27.1±1.7)kg/m², (30.2±1.3)kg, (45.4±3.1)kg, (9 406±4 452)cm³, (6 442±3 307)cm³, and (2 964±1 694)cm³ at 6 months after surgery, (24.4±2.4)kg/m², (32.6±1.1)kg, (48.6±2.7)kg, (7 612±3 029)cm³, (5 623±2 650)cm³, and (1 826±360)cm³ at 12 months after surgery, respectively, there were significant differences in the changes of these indices (F=130.2, 30.3, 4.9, 25.6, 11.9, 16.5, P<0.05). The BMI, fat mass, and TAFV at 3 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass, TSFV, and TVFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, and TVFV at 6 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass and TSFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, TSFV, and TVFV at 12 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass had no significant difference (P>0.05). (3) Follow-up: all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35. No complications such as anastomotic hemorrhage, obstruction, or anastomotic leakage occured in all the 52 patients. Conclusion Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly, while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.

To investigate the association between the change of left ventricular ( LV ) function and mechanical dispersion ( MD ) and exercise capacity in patients with hypertrophic cardiomyopathy ( HCM ) by exercise stress echocardiography . Methods Sixty‐five HCM patients [ 40 cases of hypertrophic non‐obstructive cardiomyopathy ( HNCM ) , 25 cases of hypertrophic obstructive cardiomyopathy ( HOCM ) ] and 25 control subjects were recruited .LV function ,MD and exercise capacity were evaluated by two‐dimensional speckle‐tracking imaging and echocardiography at rest and during exercise ,and the following parameters of LV function were recorded : LV global longitudinal strain ( LVGLS) ,MD ,early diastolic strain rate ( Sre) ,the ratio of peak early diastolic mitral inflow and annulus velocity ( E/e′) ,LV outflow tract gradient ( LVO TG) ; LV functional reserve was assessed by ΔLVGLS and ΔSRe ; exercise capacity was evaluated by metabolic equivalents ( M ET s ) . T he association between the change of LV function and MD and exercise capacity was investigated . Results ①Compared with normal controls ,LVO TG ,E/e′ and MD increased ,and LVGLS ,Sre , ΔLVGLS , ΔSRe and M ET s decreased in HNCM patients at rest and during exercise ( all P ＜ 0 .05 ) . ② LVO TG , E/e′ and MD were further increased ,LVLGS ,Sre ,ΔSRe and M Ets were further reduced in HOCM patients compared with HNCM patients ( all P ＜ 0 .05 ) . ③LVGLS and MD measured at peak exercise were associated with M ET s ( r ＝－0 .68 , P ＜ 0 .001 ; r ＝ －0 .43 , P ＜ 0 .001 ) . ④ ROC curve analysis showed LVGLS had a better predictive value for exercise intolerance in HCM patients ,followed by E/e′ and MD . Conclusions LV function and mechanic reserve are reduced but MD is increased in HCM patients ,especially in HOCM patients . Exercise capacity is associated with LV function and MD ,w hich can predict the reduced exercise capacity in HCM patients .