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 compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

Objective:To compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

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 study the relationship between lipid metabolism and liver function indexes in prediabetic population,and explore the predictive value of these indexes for prediabetes.Methods 546 patients with prediabetes who underwent physical examination in the First Affiliated Hospital of Xi'an Jiaotong University from April 2020 to August 2021 were selected as case group(PreDM group)and 546 patients with normal glucose tolerance as control group(NGT group).There was no significant difference in baseline data between the two groups after tendency matching score.The levels of lipid metabolism and liver function indicators were compared between the two groups;the correlation between lipid metabolism and liver function indicators in the PreDM group was analyzed;the influencing factors of prediabetes were screened by using binary logistic regression analysis;the predictive effect of lipid metabolism and liver function indicators on prediabetes was judged by using the ROC curve.Results Glutamic pyruvic transaminase(ALT),glutamic pyruvic transaminase/glutamic oxaloacetic transaminase ratio(ALT/AST),cholinesterase(CHE),gamma glutamyltransferase(GGT),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol/high density lipoprotein cholesterol ratio(TC/HDL-C)and triglyceride/high density lipoprotein cholesterol ratio(TG/HDL-C)in PreDM group were higher than those in NGT group(all P＜0.05).Spearman correlation analysis showed that TG/HDL-C in PreDM group had the positive correlation with ALT,ALT/AST,CHE and GGT(r=0.256,0.256,0.293,0.122,all P＜0.05).Multivariate stepwise logistic regression analysis showed that ALT/AST,GGT,TC/HDL-C and TG/HDL-C had the greatest effect on prediabetes(OR=2.124,1.027,1.196,1.260),and the combination of the four had the highest differential diagnostic value(AUC＞0.70).Conclusion There are more abnormal indexes of blood lipid and liver zymogram in prediabetic population,and the combination of ALT/AST,GGT,TC/HDL-C and TG/HDL-C is more effective in predicting prediabetes.

Objective To survey the levels and distributed status of serum vitamin D in children in Hanzhong city of Shaanxi,and provide a basis for the prevention of children with vitamin D deficiency.Methods A total of 6 780 children aged 1 to 6 years from March 2019 to February 2021 in Children's Health Clinic of Hanzhong Center Hospital for physical examination were selected as subjects.The levels of serum 25-hydroxyvitamin D[25(OH)D],serum 25-hydroxyvitamin D2[25(OH)D2]and serum 25-hydroxyvitamin D3[25(OH)D3]were measured by liquid chromatography-tandem mass spectrometry(LC-MS/MS),and the factors of ages and sexes and seasons were analyzed.Results The levels of serum 25(OH)D,25(OH)D2 and 25(OH)D3 in all children were 38.24±9.84 ng/ml,2.31±3.91 ng/ml and 35.93±9.93 ng/ml,respectively.The vitamin D deficiency rate,insufficiency rate and adequacy rate were 2.75％(186/6 780),18.29％(1 240/6 780)and 78.96％(5 354/6 780),respectively.The levels of serum 25(OH)D and 25(OH)D3 in children aged 1～2,2～3 and 3～6 years were gradually decreased with the growth of age,while the rate of vitamin D deficiency was increased,with significant differences(F=1 153.499,1 165.341,1 374.051,all P＜0.05).There were no significant differences in distributed status of serum of vitamin D and the levels of serum 25(OH)D,25(OH)D2 and 25(OH)D3 levels among different genders(t/x2=0.727,1.271,0.222,2.659,all P＞0.05).The levels of serum 25(OH)D and 25(OH)D3 in winter were lower than those in spring,summer and autumn,and the differences were statistically significant(q=6.853,7.281,6.801;5.341,6.225,5.989,all P＜0.01).The vitamin D deficiency rate in winter was higher than that in spring,summer and autumn(6.60％,2.64％,1.91％,1.66％).and the differences were statistically significant(x2=31.733,52.252,57.756,all P＜0.01).Conclusion A high incidence of vitamin D deficiency or insufficiency was found in children aged 3 to 6 in Hanzhong city.It was necessary to strengthen outdoor activities in winter,encourage monitoring of serum vitamin D levels,and supplement vitamin D if necessary.

Objective: To analyze the efficacy of recombinant activated factor Ⅶ a (rF Ⅶ a) on hematonosis with moderate or severe bleeding signs. Methods: Of total 16 cases with rF Ⅶ a treatment from May 2013 to May 2016, 8 cases received allogeneic hematopoietic stem cells transplantation (allo-HSCT) and the other were non-transplantation patients. In two groups, there was no significant difference on rF Ⅶ a usage and dosage. 15 patients with acute graft-versus-host disease (aGVHD) after allo-HSCT were control group (without rF Ⅶ a) . Results: ①The total response rate was 75.0% (6/8) in non-transplantation group and 37.5% (3/8) in transplantation group, respectively. Median interval for hemorrhage stop was 38.5 hours in non-transplantation group and 63.0 hours in transplantation group. The median overall survival (OS) was 201.0 and 29.0 days for non-transplantation group and transplantation group, respectively, and the OS rate was 50.0% (4/8) and 25.0% (2/8) , respectively. The bleeding-related mortality rate was 50.0% (2/4) and 83.3% (5/6) , respectively. ②Of the 16 cases, 9 showed response to rF Ⅶ a treatment and the other 7 cases’bleeding signs did not alleviate. The median OS was 268.0 in 9 cases with response and 24.0 days in 7 cases without response, respectively. ③In patients with intestinal aGVHD complicated with intestinal hemorrhage, the median OS of observation group (n=6) and control group (n=15) were 25.5 days and 20.0 days, respectively. Conclusion Patients with hematological diseases, especially patients after allo-HSCT, had high bleeding-related mortality, and rFⅦa therapy had a obvious hemostatic efficacy. The survival rate of patients with response was higher than that of cases without response. The causes of poor hemostasis efficacy of rF Ⅶ a therapy were associated with unsatisfactory control of complications in patients with intestinal bleeding after allo-HSCT.

OBJECTIVE:To evaluate the effectiveness of Liuwei wuling tablets combined with entecavir in the treatment of chronic hepatitis B (CHB),and to provide evidence-based reference in clinic.METHODS:Retrieved from Cochrane library,PubMed,Web of Science,CJFD,Wanfang database and VIP,randomized controlled trials (RCTs) about Liuwei wuling tablets combined with entecavir (trial group) vs.entecavir alone (control group) in the treatment of CHB were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 8 RCTs were included,involving 728 patients.Results of Meta-analysis showed that the levels of ALT [MD=-16.67,95 ％ CI (-19.83,-13.51),P＜ 0.001],AST [MD =-20.52,95％ CI (-25.65,-15.39),P＜0.001] and TBIL [MD=-5.85,95％CI(-11.31,-0.38),P=0.04] in trial group were significantly lower than control group;clinical total response rate [RR=1.23,95％CI(1.03,1.46),P=0.02] and HBeAg negative conversion rate [RR=1.26,95％CI(1.03,1.54),P=0.02] were significantly higher than control group,with statistical significance.There was no statistical significance in the rate of serum HBV DNA negative conversion [RR=1.22,95％ CI(0.99,1.52),P=0.07] between 2 groups.CONCLUSIONS:Compared with entecavir alone,Liuwei wuling tablets combined with entecavir in the treatment of CHB have better efficacy,can significantly improve the biochemical indexes of liver function in patients.

Objective To explore the correlation between myeloperoxidase(MPO) and white blood cell (WBC) and other related numerical values in blood .Methods 50 common patients were randomly selected .The two blood samples in each patient were re-spectively collected by the biochemical tube anticoagulated by heparin sodium and the blood routine tube anticoagulated by ethylene diamine tetraacetic acid kalium(EDTA-K2 ) .Then plasma MPO content and WBC count ,absolute neutrophils count ,percentage of neutrophils ,platelet count in whole blood were detected .The MPO content and the above 4 items of detection results were per-formed the correlation analysis .Results The correlation coefficients(r) between plasma MPO with WBC count ,neutrophils count , percentage of neutrophils and platelet count in whole blood were 0 .253 ,0 .220 ,0 .111 and 0 .133 respectively ,which indicating that no correlation existed between them .Conclusion Blood MPO is mainly derived from polymorphonuclear neutrophils ,but WBC count ,neutrophils count and platelet count in whole blood do not cause the change of the myeloperoxidase content .