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 differential diagnostic value of three gastric function indicators and Helicobacter pylori ( Hp) antibody combined detection in early gastric cancer and precancerous lesions. Methods:A total of 103 patients with gastric cancer (gastric cancer group), 103 patients with precancerous lesions (precancerous lesion group) and 103 healthy physical examination subjects (healthy group) admitted to the Emergency Management Department Emergency General Hospital from December 2020 to December 2022 were retrospectively selected as the study objects. Three gastric function tests and 14C breath test were performed in all three groups. The levels of three gastric function indicators and Hp antibody were compared among the three groups. According to the results of 14C breath test, gastric cancer patients were divided into the positive group and the negative group, and the levels of the three gastric function indicators were compared between the two groups. Results:The serum levels of pepsinogen Ⅱ (PGⅡ) and gastrin 17 (G-17) in the gastric cancer group were higher than those in the precancerous lesion group and healthy group: (18.32 ± 4.72) μg/L vs. (13.83 ± 3.63), (11.56 ± 3.47) μg/L; (74.82 ± 8.89) μg/L vs. (61.07 ± 7.51), (49.14 ± 5.29) μg/L; the levels of pepsinogen Ⅰ (PGⅠ) and pepsinogen ratio (PGR, PGⅠ/ PGⅡ) were lower than those in the precancerous lesion group and healthy group: (35.83 ± 5.93) μg/L vs. (73.05 ± 7.23), (86.27 ± 8.48) μg/L; 1.96 ± 0.54 vs. 5.28 ± 1.00, 7.46 ± 1.02, there were statistical differences ( P<0.05). The positive rates of Hp antibody in gastric cancer group, precancerous lesion group and healthy group were 65.05% (67/103), 33.01%(34/103) and 11.65% (12/103), respectively, there was a statistically significant difference in the positive rates of Hp antibody among the three groups ( χ2 = 64.15, P<0.05). The positive rate of Hp antibody was the highest in gastric cancer group, followed by precancer group, and the lowest in healthy group.The levels of PGⅠand PGR in patients with positive 14C breath test in the gastric cancer group were lower than those with negative results: (25.79 ± 3.63) μg/L vs. (41.82 ± 4.71) μg/L, 1.28 ± 0.42 vs. 2.40 ± 0.56, while the levels of PGⅡ and G-17 were higher than those with negative results: (20.35 ± 3.59) μg/L vs. (17.46 ± 3.52) μg/L, (83.72 ± 10.84) μg/L vs. (65.07 ± 7.76) μg/L, there were statistical differences ( P<0.05). Conclusions:The combined detection of gastric function and Hp antibody can serve as important screening indicator for evaluating gastric cancer and precancerous lesions.

BACKGROUND:A large number of studies have shown that neurodegenerative diseases are closely related to oxidative stress injury and the imbalance of mitochondrial dynamics.Lycium barbarum polysaccharides have a neuroprotective effect.However,it is not clear whether lycium barbarum polysaccharides can ameliorate apoptosis induced by oxidative stress injury by regulating abnormal mitochondrial dynamics.OBJECTIVE:To study the effect of lycium barbarum polysaccharides on apoptosis induced by H2O2 in SH-SY5Y human neuroblastoma cells.METHODS:SH-SY5Y cells were cultured in three groups.The control group was cultured for 24 hours.The hydrogen peroxide group was treated with H2O2 for 24 hours,and the lycium barbarum polysaccharide group was treated with lycium barbarum polysaccharide for 2 hours and then treated with H2O2 for 24 hours.After treatment,the levels of malondialdehyde,glutathione,and superoxide dismutase in the precipitation of the cells were detected by kit.Mitochondrial membrane potential was detected by JC-1 kit.Cell viability was detected by MTT assay.Apoptosis was detected by TUNEL.The expression levels of mitochondrial dynamics-related proteins (phosphorylated promoter protein 1,mitochondrial fission protein 1,mitochondrial fusion protein 1,mitochondrial fusion protein 2,and optic atrophy protein 1) and apoptotic proteins (Bax,Bcl-2,and Caspase-3) were detected by immunofluorescence staining and western blot assay.RESULTS AND CONCLUSION:(1) Compared with the control group,the levels of malondialdehyde were increased (P<0.05),and the levels of superoxide dismutase and glutathione were decreased (P<0.05) in the H2O2 group.Compared with the H2O2 group,the malondialdehyde level was decreased (P<0.05),and the superoxide dismutase and glutathione levels were increased (P<0.05) in the lycium barbarum polysaccharide group.(2) The mitochondrial membrane potential in the H2O2 group was lower than that in the control group (P<0.05),and that of lycium barbarum polysaccharide group was higher than that of the H2O2 group (P<0.05).(3) Compared with the control group,the apoptosis rate and the expression of Bax and Caspase-3 protein were increased (P<0.05),while the cell viability and the expression of Bcl-2 protein were decreased (P<0.05) in the H2O2 group.Compared with the H2O2 group,the apoptosis rate and the expression of Bax and Caspase-3 protein were decreased (P<0.05),while the cell viability and the expression of Bcl-2 protein were increased (P<0.05) in the lycium barbarum polysaccharide group.(4) Compared with the control group,the protein expression levels of phosphorylated promoter protein 1 and mitochondrial fission protein 1 were increased (P<0.05),and the protein expression levels of mitochondrial fusion protein 1,mitochondrial fusion protein 2,and optic atrophy protein 1 were decreased (P<0.05) in the H2O2 group.Compared with the H2O2 group,the protein expression levels of phosphorylated promoter protein 1 and mitochondrial fission protein 1 were decreased (P<0.05),and the protein expression levels of mitochondrial fusion protein 1,mitochondrial fusion protein 2,and optic atrophy protein 1 were increased (P<0.05) in the lycium barbarum polysaccharide group.(5) These results indicate that lycium barbarum polysaccharide can improve SH-SY5Y cell apoptosis caused by oxidative stress damage by regulating mitochondrial dynamics.

Type 2 diabetes mellitus(T2DM)is a chronic metabolic disorder caused by a combination of genetic and environmental factors.The epigenetic transcriptional modifications after RNA transcription can affect gene expression and glucose homeostasis.N6-methyladenine(m6A),as an RNA methylation modification,plays an important role in the pathogenesis of T2DM.This article reviews the research progress of m6A methylation in T2DM.

Objective To explore the value of deep learning image reconstruction(DLIR)by comparing subjective and objec-tive evaluation of DLIR and adaptive statistical iterative reconstruction(ASIR-V)images in gastric cancer CT.Methods Abdominal CT images in the venous phase of 80 untreated patients with primary gastric cancer were included,and five CT reconstruction meth-ods of 50％ASIR-V,80％ASIR-V,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)were adopted,respec-tively.The objective evaluation included background standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)values and pericancerous fat density resolution.The subjective evaluation included SD,overall image quality,the display of gastric cancer lesions,and diagnostic confidence in whether the serosal surface of the gastric wall was infiltrated.Results The subjective and objective evalua-tion indicators showed statistically significant differences among the five reconstruction models(P＜0.001).In terms of objective evalua-tion,the SD value of gastric cancer lesions in the DLIR-H was the lowest,while the SNR and CNR values were the highest among the five groups.In terms of subjective evaluation,the DLIR-M had the highest scores in gastric cancer lesions display,overall image quality and diagnostic confidence among the five groups.Conclusion Compared with ASIR-V,DLIR can significantly reduce image noise and improve image quality,and DLIR-M and DLIR-H are respectively the optimal subjective and objective reconstruction models for showing gastric cancer lesions.

Objective Investigate the clinical efficacy and application value of gasless trans-subclavian approach endoscopic surgery(GTAES)for the treatment of primary hyperparathyroidism(PHPT).Methods 55 PHPT patients who underwent unilateral parathyroid adenoma resection from January 2023 to October 2024 were absorbed.Based on surgical approaches,31 patients were divided into the traditional low-collar arc incision open surgery group(open group)and 24 patients were divided into gasless trans-subclavian approach endoscopic surgery group(endoscopic group).The perioperative data,anterior neck function recovery,and incision healing were compared between two groups.Results There were no significant differences in operation time,intraoperative blood loss,postoperative drainage volume and postoperative hospital stay between the two groups(P＞0.05).The preoperative blood calcium levels of the endoscopic group and the open group were(2.68±0.10)mmol/L and(2.63±0.16)mmol/L,respectively.The blood calcium levels on the first day after surgery were(2.39±0.12)mmol/L and(2.36±0.16)mmol/L,respectively.Preoperative parathyroid hormone(PTH)was 27.55(110.05,155.75)pg/ml in endoscopic group and 137.00(107.00,210.30)pg/ml in open group,respectively.PTH on the first day after surgery was 18.98(12.64,23.53)pg/ml and 13.85(7.36,23.23)pg/ml,respectively.Blood calcium and PTH in each group 1 day after surgery decreased compared with that before surgery,and the difference was statistically significant(P＜0.05).There were no postoperative complications such as hoarseness,bleeding and incision infection in both groups.Postoperative hand and foot numbness:5 cases(20.8％)in endoscopic group and 8 patients(25.8％)in the open group,there was no significant difference between the two groups(P=0.667).There was no significant difference in the score of neck pain 3 days after surgery between the two groups(P＞0.05).The score of swallowing tension[(1.92±1.06)points compared with(2.77±1.38)points,P=0.015]and the score of anterior neck discomfort[(1.63±0.88)points compared with(2.35±1.33)points,P=0.018]in the endoscopic group one month after surgery were better than those in the open group.There was no significant difference in the score of neck scar scale between the two groups 3 months after surgery(P＞0.05).VAS score of incision satisfaction was(9.08±0.88)in endoscopic group and(8.19±1.30)in open group,and the endoscopic group was better than the open group,the difference was statistically significant(P=0.004).Conclusion For PHPT patients caused by unilateral parathyroid adenoma confirmed through preoperative localization examination,GTAES is a safe and effective surgical approach,which offers unique advantages in intraoperative lesion identification,cosmetic outcomes of the incision,and preservation of anterior neck function,providing a new surgical option for PHPT patients.

To investigate the application value of disposable subscope-assisted intestinal metal stent placement in the treatment for acute malignant colorectal obstruction, a retrospective analysis was conducted on the patients who underwent intestinal metal stent placement assisted by disposable subscope for acute malignant colorectal obstruction at the Digestive Endoscopy Center, Affiliated Hospital of Yangzhou University from June 2023 to July 2024. The technical success rate, clinical success rate, operation time, postoperative complications and first-stage surgical resection anastomosis rate of intestinal metal stent placement assisted by subscope were analyzed. Among the 16 included patients, there were 10 males and 6 females, with the age of 72.19±9.40 years. Obstruction occurred at the descending colon in 8 cases (50.00%), at the sigmoid colon in 6 cases (37.50%), at the rectosigmoid junction in 1 case (6.25%), and at the splenic flexure of the transverse colon in 1 case (6.25%). All 16 patients successfully underwent stent placement, with a technical success rate of 100.00% (16/16). Obstruction symptoms did not relieve in one patient (6.25%) after stent placement, resulting in a clinical success rate of 93.75% (15/16). The endoscopic operation time for the 16 patients was 37.8±13.9 minutes. No bleeding, perforation, stent displacement, or detachment occurred after the operation. Fourteen patients underwent subsequent surgical treatment, the first-stage surgical resection anastomosis rate was 71.43% (10/14). This preliminary study suggests that the disposable subscope-assisted intestinal metal stent placement for the treatment of acute malignant colorectal obstruction is safe and effective, with no radiation exposure.

Diabetic peripheral neuropathy (DPN) is one of the common chronic complications of diabetes, presenting with neuropathic pain, sensory abnormalities, and sensory loss, and may lead to foot infections, ulcers, or amputation in severe cases. Its pathogenesis remains unclear, with challenge in early diagnosis and limited treatment efficacy. Emerging evidences suggest that DPN involves in not only the peripheral nervous system but also the central nervous system (CNS). With advances in imaging technologies, multimodal MRI has become a key tool to investigate CNS involvement in DPN. This review summarizes the structural, functional, metabolic, and perfusion-related CNS changes in DPN patients based on structural MRI, functional MRI, MR spectroscopy, and perfusion-weighted imaging, aiming to help early detection, clinical subtyping, and personalized treatment of DPN.

OBJECTIVES: Near vision loss (NVL) is one of the leading causes of visual impairment worldwide, exerting a profound impact on individual quality of life and socio-economic development. This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years. METHODS: Using data from the Global Burden of Disease (GBD) 2021 database, we conducted descriptive analyses of NVL prevalence in China, calculated age-standardized prevalence rates (ASPR) and age-standardized disability-adjusted life years rates (ASDR) to compare burden differences between sexes and age groups, and applied an autoregressive integrated moving average (ARIMA) model to predict NVL trends for the next 15 years. The model selection was based on best-fit criteria to ensure reliable projections. RESULTS: From 1990 to 2021, China's ASPR of NVL rose from 10 096.24/100 000 to 15 624.54/100 000, and ASDR increased from 101.75/100 000 to 158.75/100 000. In 2021, ASPR (16 551.70/100 000) and ASDR (167.69/100 000) were higher among females than males (14 686.21/100 000 and 149.76/100 000, respectively). China ranked highest globally in both NVL cases and disability-adjusted life years (DALYs), with female burden significantly exceeding male burden. Projections indicated this trend and sex gap will persist until 2036. Compared with 1990, the prevalence cases and DALYs increased by 239.20% and 238.82%, respectively in 2021, with the highest burden among females and the 55-59 age group. The ARIMA model predicted continued increases in prevalence and DALYs by 2036, with females maintaining a higher burden than males. CONCLUSIONS This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years. Public health policies should prioritize NVL prevention and control, with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.
Humans ; China/epidemiology* ; Male ; Female ; Prevalence ; Middle Aged ; Disability-Adjusted Life Years ; Adult ; Global Burden of Disease ; Adolescent ; Quality-Adjusted Life Years ; Aged ; Sex Factors ; Child ; Young Adult ; Child, Preschool ; Cost of Illness ; Infant ; Aged, 80 and over ; Vision Disorders/epidemiology*