Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

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.

Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

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 observe the effect of the combination therapy of Qingtong formula and Dapagliflozin on the renal function of diabetic mice.Methods:A total of 24 10-week-old diabetic model（db/db）mice were selected and divided into four groups with six db/db mice in each group by random number table method：db/db mice（control group），db/db mice + Dapaglifozin（western medicine group），db/db mice + Dapagliflozin + Qingtong formula［traditional Chinese medicine（TCM）combined with western medicine group］，and db/db mice + Qingtong formula（TCM group）. The changes of urine creatinine and urinary albumin / creatinine（ACR）before and after treatment were compared，and the levels of serum creatinine and urea nitrogen after treatment were also compared.Results:After treatment，the serum creatinine level in the TCM combined with western medicine group showed a downward trend compared with that of the control group and significantly decreased compared with the western medicine group and the TCM group，and the difference was statistically significant（ P < 0.01）. There was no significant difference in urea nitrogen level among all groups（ P > 0.05）. After treatment，urinary creatinine level in the TCM combined with western medicine group was significantly higher than those in other three groups，with statistical significance differences（ P < 0.05 or P < 0.01）. There was no significant difference in urinary ACR level among groups before and after treatment（ P > 0.05）. Conclusion:The combination therapy of Qingtong formula and Dapaglifozin can significantly increase urine creatinine excretion of db/db mice，lower the level of serum creatinine，thus improving renal function.

Objective:To observe the effect of the combination therapy of Qingtong formula and Dapagliflozin on the renal function of diabetic mice.Methods:A total of 24 10-week-old diabetic model（db/db）mice were selected and divided into four groups with six db/db mice in each group by random number table method：db/db mice（control group），db/db mice + Dapaglifozin（western medicine group），db/db mice + Dapagliflozin + Qingtong formula［traditional Chinese medicine（TCM）combined with western medicine group］，and db/db mice + Qingtong formula（TCM group）. The changes of urine creatinine and urinary albumin / creatinine（ACR）before and after treatment were compared，and the levels of serum creatinine and urea nitrogen after treatment were also compared.Results:After treatment，the serum creatinine level in the TCM combined with western medicine group showed a downward trend compared with that of the control group and significantly decreased compared with the western medicine group and the TCM group，and the difference was statistically significant（ P < 0.01）. There was no significant difference in urea nitrogen level among all groups（ P > 0.05）. After treatment，urinary creatinine level in the TCM combined with western medicine group was significantly higher than those in other three groups，with statistical significance differences（ P < 0.05 or P < 0.01）. There was no significant difference in urinary ACR level among groups before and after treatment（ P > 0.05）. Conclusion:The combination therapy of Qingtong formula and Dapaglifozin can significantly increase urine creatinine excretion of db/db mice，lower the level of serum creatinine，thus improving renal function.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Objective To explore the levels of serum adiponectin (ADPN) and retinol-binding protein 4 (RBP4) in patients with type 2 diabetes mellitus (T2DM) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods A total of 155 patients with T2DM and OSAHS were selected and divided into mild group (n=62),moderate group (n=53) and severe group (n=40) according to apnea-hypopnea index (AHI),35 OSAHS patients were designed as OSAHS group,42 T2DM patients were selected as T2DM group,and 38 healthy controls were selected as control group.Serum ADPN and RBP4 levels were detected by ELISA.Results Compared with healthy controls,the serum level of RBP4 significantly increased and the ADPN level significantly decreased in the other three groups (P<0.01).In subgroups of OSAHS and T2DM group,the level of RBP4 increased with increasing of AHI level,ADPN level is on the contrary (P<0.01).Conclusion The serum levels of ADPN and RBP4 are closely related with the severity of T2DM patients with OSAHS.

Objective To explore the levels of serum adiponectin (ADPN) and retinol-binding protein 4 (RBP4) in patients with type 2 diabetes mellitus (T2DM) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods A total of 155 patients with T2DM and OSAHS were selected and divided into mild group (n=62),moderate group (n=53) and severe group (n=40) according to apnea-hypopnea index (AHI),35 OSAHS patients were designed as OSAHS group,42 T2DM patients were selected as T2DM group,and 38 healthy controls were selected as control group.Serum ADPN and RBP4 levels were detected by ELISA.Results Compared with healthy controls,the serum level of RBP4 significantly increased and the ADPN level significantly decreased in the other three groups (P<0.01).In subgroups of OSAHS and T2DM group,the level of RBP4 increased with increasing of AHI level,ADPN level is on the contrary (P<0.01).Conclusion The serum levels of ADPN and RBP4 are closely related with the severity of T2DM patients with OSAHS.

With the continuous innovation and development in the field of interventional therapy, the complexity of surgery has been gradually increased, meanwhile, the psychological expectation from patients for a minimally invasive surgery has also become higher and higher. Patients expect not only to be safe to complete the surgery, but also to maintain the comfort during operation process. For ensuring these demands, anesthesia plays a key role. This paper aims to discuss the current situation, problems and development direction of anesthesia application in interventional surgeries in order to help promote the anesthesia management concepts in performing interventional procedures.