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.

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 develop a noninvasive method for prediction of 1p/19q codeletion in diffuse lower-grade glioma (DLGG) based on multimodal magnetic resonance imaging (MRI) radiomics. METHODS: We collected MRI data from 104 patients with pathologically confirmed DLGG between October, 2015 and September, 2022. A total of 535 radiomics features were extracted from T₂WI, T₁WI, FLAIR, CE-T₁WI and DWI, including 70 morphological features, 90 first order features, and 375 texture features. We constructed logistic regression (LR), logistic regression least absolute shrinkage and selection operator (LRlasso), support vector machine (SVM) and Linear Discriminant Analysis (LDA) radiomics models and compared their predictive performance after 10-fold cross validation. The MRI images were reviewed by two radiologists independently for predicting the 1p/19q status. Receiver operating characteristic curves were used to evaluate classification performance of the radiomics models and the radiologists. RESULTS: The 4 radiomics models (LR, LRlasso, SVM and LDA) achieved similar area under the curve (AUC) in the validation dataset (0.833, 0.819, 0.824 and 0.819, respectively; P>0.1), and their predictive performance was all superior to that of resident physicians of radiology (AUC=0.645, P=0.011, 0.022, 0.016, 0.030, respectively) and similar to that of attending physicians of radiology (AUC=0.838, P>0.05). CONCLUSION Multiparametric MRI radiomics models show good performance for noninvasive prediction of 1p/19q codeletion status in patients with in diffuse lower-grade glioma.
Humans ; Magnetic Resonance Imaging ; Chromosome Aberrations ; Area Under Curve ; Glioma/genetics* ; ROC Curve

Objective:To investigate the relationship between bone mineral density (BMD) of lumbar spine and abdominal adipose tissue in adult males.Methods:A total of 1 374 healthy male examinees in the Affiliated Hospital of Guizhou Medical University from June 2018 to September 2018 were retrospectively analyzed. The age ranged from 30 to 75 (50.9±0.30) years. Height, weight and waist circumference was measured and body mass index (BMI) was calculated. Quantitative CT (QCT) was used to measure the mean BMD value of L1 and L2. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) at the level of L2 were measured as well. According to the BMD, the males were divided into three groups: normal group, osteopenic group and osteoporosis group. One-way ANOVA was applied to compare the age, BMI, VFA and SFA among three groups. LSD- t test was used for multiple comparisons, and Pearson correlation was used to analyze the correlation between age, BMI, VFA, SFA and lumbar BMD. Results:Totally 807 healthy males were in normal group, 451 in osteopenic group and 116 in osteoporosis group. There were significant differences in age, BMI and VFA among normal group, osteopenic group and osteoporosis group ( F=237.939, 5.788, 4.919, P<0.001, 0.003, 0.007). Age and VFA was higher in osteopenic group compared with normal group, and BMI was lower in osteopenic group compared with normal group. Age was higher in osteoporosis group compared with normal group, and the BMI was lower in osteoporosis group compared with normal group. The age was higher in osteoporosis group compared with osteopenic group. The above differences were statistically significant ( P<0.05). Although there was no statistical difference in VFA and SFA between osteopenic group and osteoporosis group, the VFA and SFA was higher in osteopenic group compared with osteoporosis group. BMD of male lumbar spine was negatively correlated with age ( r=-0.542, P<0.001), VFA( r=-0.104, P<0.001), and positively correlated with BMI ( r=0.109, P<0.001). After controlling for age and BMI, BMD was still negatively correlated with VFA ( r=-0.129, P<0.05). Conclusions:Males with abdominal obesity is more likely to manifest as low bone mass. The lumbar BMD is possibly negatively correlated with visceral adipose tissue in male.

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

Objective To evaluate the feasibility of wholeGtumor texture analysis of contrastGenhanced T1 WI (T1 Ce)in differentiating cystic glioma (CG)from brain abscess (BA).Methods MRI data of 25 cases of ringGenhanced CG and 24 cases of BA proven pathologically were retrospectively studied.All the patients underwent preGsurgery MRI plain and contrastGenhanced scans.FireVoxel software was used to outline the ROI of the wholeGtumor.The signal intensity histogram and related texture parameters of the 3D ROI were obtained,including mean, median,standard deviation,inhomogeneity,skewness,kurtosis and entropy.The data were first tested for normality and the differences in wholeG tumor texture analysis parameters of T1 Ce between CGs and BAs were compared using the independentGsample t test(normal distribution)and MannGWhitney rank sum test (skewed distribution).ROC curve was used to evaluate the efficacy of the parameter in differentiating CG from BA.Results There were statistical significances in the parameters of mean,median,standard deviation,inhomogeneity and skewness between CGs and BAs(P＜0.05),and there were no any statistical significances in kurtosis and entropy between CGs and BAs(P＞0.05).In all the texture parameters,the AUC of inhomogeneity was the largest(0.988),and when the threshold was 0.314, the sensitivity and the specificity were 92.60% and 9 7.1 0%,respectively.Conclusion Some of the quantitative parameters of the wholeGtumor texture analysis of T1 Ce(mean,median,standard deviation,inhomogeneity and skewness)could provide reliable and objective evidences for imaging differential diagnosis of CG and BA preGsurgery.

Objective To evaluate the surgical management of pancreatic fistula caused by pan-creatic trauma and pancreatitis through surgical drainage. Methods A series of 45 patients with pancreat-ic fistula undergoing Roux-en-Y surgery with or without fistulectomy from 2004 to 2014 was analyzed. Pa-tients were divided into two groups:patients in group A(n=21)underwent external drainage of pancreatic secretion by Roux-en-Y surgery,and patients in group B(n= 24)underwent Roux-en-Y surgery with fistu-lectomy. The surgery was performed at 4~6 months after formation of the fistula,and somatostatin was used postoperatively. Results Patients in group A developed more severe side effects than patients in group B, including chronic abdominal pain(6/21 vs. 1/24),pancreatic leakage(8/21 vs. 2/24),digestive bleeding (5/21 vs. 5/24)and incision infection(9/21 vs. 3/24). Conclusion Resection of the fistula plus Roux-en-Y surgery can significantly reduce the incidence of surgical complications,which is a safe and efficient management for pancreatic fistula.

OBJECTIVETo investigate the mechanism through which Liuweidihuangwan improves hepatic insulin resistance in type 2 diabetic rats.

METHODSWith LETO rats as the normal control group, OLETF rats were treated daily with or without Liuweidihuangwan. At 8, 32, and 40 weeks of the treatment, 3 rats were randomly selected from each group for histological examination of the liver tissues and for detection of phosphoenolpyruvate carboxylase kinase (PEPCK) mRNA expression using RT-PCR and insulin receptor substrate-1 (IRS-1) and IRS-2 protein expressions using Western blotting.

RESULTSCompared with LETO rats, OLETF rats showed progressive destruction of the lobular structures and hepatic steatosis in the liver over time. OLETF rats with Liuweidihuangwan treatment had basically normal lobular structure with only mild fatty degeneration in the liver. RT-PCR detection demonstrated a significantly higher PEPCK mRNA expression in untreated OLETF rats than in LETO rats (P<0.01), but a significantly lowered PEPCK expression in OLETF rats after Liuweidihuangwan dosing (P<0.01). Western blotting showed that significantly lower p-IRS-1 and p-IRS-2 protein expressions in untreated OLETF rats than those in LETO rats and treated OLTEF rats (P<0.05).

CONCLUSIONLiuweidihuangwan improves hepatic insulin resistance in OLETF rats by inhibiting the activity of gluconeogenic key enzyme (PEPCK) in the liver and enhancing IRS-1 and IRS-2 expressions in the insulin signaling pathway.

Animals ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Insulin Receptor Substrate Proteins ; metabolism ; Insulin Resistance ; Intracellular Signaling Peptides and Proteins ; metabolism ; Liver ; drug effects ; metabolism ; pathology ; Male ; Phosphoenolpyruvate Carboxykinase (GTP) ; metabolism ; Rats ; Rats, Inbred OLETF ; Signal Transduction

OBJECTIVETo investigate the protective effects of exendin-4 on vascular endothelial cells and explore the possible mechanism.

METHODSHuman umbilical vascular endothelial cells (HUVECs) were cultured in the presence of high glucose and tumor necrosis factor-α (TNF-α, 10 ng/ml) with or without exendin-4. The level of nitric oxide (NO) in the cell culture supernatant was measured using a nitrate reductase method. The expression of intercellular adhesion molecule-1 (ICAM-1) mRNA was measured by real-time PCR, and nuclear factor-κB (NF-κB) p65 translocation was detected using immunofluorescence assay. Western blotting was employed to measure the expression of p38 MAPK protein in the treated cells.

RESULTSIn the presence of high glucose and TNF-α, treatment of cells with exendin-4 did not obviously affect the cellular synthesis of NO, but significantly down-regulated the expression of ICAM-1 mRNA (P<0.01). The nuclear fluorescence intensity of NF-κB p65 and the expression level of p38 MAPK protein in the cells were significantly lowered by exendin-4 treatment (P<0.01).

CONCLUSIONExendin-4 ameliorates high glucose- and TNF-α-induced HUVEC-12 cell damage by inhibiting the expression of p38 MAPK protein and translocation of NF-κB p65.

Cell Line ; Culture Media ; chemistry ; Glucose ; adverse effects ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Peptides ; pharmacology ; Transcription Factor RelA ; metabolism ; Tumor Necrosis Factor-alpha ; adverse effects ; Venoms ; pharmacology ; p38 Mitogen-Activated Protein Kinases ; metabolism