Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

ObjectiveTo explore the effect of Polygonati Odorati Rhizoma polysaccharides on hyperlipidemia in mice by modulating the gut microbiota. MethodsNinety male C57BL/6J mice were randomized into the following groups （n=15）： control， model， simvastatin， low- （100 mg·kg^-1）， medium- （200 mg·kg^-1）， and high-dose （400 mg·kg^-1） Polygonati Odorati Rhizoma polysaccharides groups. Other groups except the control group were fed with a high-fat diet for the modeling of hyperlipidemia， and drug interventions lasted for 12 weeks. Serum levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were measured by an automatic biochemical analyzer. The pathological changes in the liver and epididymal fat were observed by hematoxylin-eosin staining， and lipid accumulation in the liver was assessed by oil red O staining. The gut microbiota was analyzed by 16S rRNA gene sequencing. ResultsCompared with the control group， the model group exhibited an increase in body weight （P<0.01）， along with marked elevations in serum levels of TC， TG， and LDL-C （P<0.05，P<0.01）. Furthermore， the model group showcased increase in the liver index and epididymal fat coefficient （P<0.05）， increased liver fat accumulation， enlargement of adipocytes in the epididymal fat， decreases in both alpha and beta diversity of the gut microbiota， and an increase in the relative abundance of Allobaculum （P<0.01）. Compared with the model group， Polygonati Odorati Rhizoma polysaccharides suppressed the increase in body weight （P<0.01）， lowered the serum levels of TC， TG， and LDL-C （P<0.05，P<0.01）， reduced the liver index and epididymal fat coefficient （P<0.05）， alleviated liver fat accumulation， and decreased the size of adipocytes in the epididymal fat. Furthermore， it enhanced the alpha and beta diversity of the gut microbiota in mice， reduced the relative abundance of Allobaculum， Erysipelotrichaceae， and Clostridium （P<0.01）， and increased the relative abundance of Akkermansia and Blautia （P<0.01）. ConclusionPolygonati Odorati Rhizoma polysaccharides can ameliorate hyperlipidemia induced by a high-fat diet in mice by regulating the diversity and composition of the gut microbiota.

ObjectiveTo explore the effect of a novel initiation model on initiating behavioral requests in children with autism spectrum disorder (ASD). MethodsFrom November to December, 2022, 44 children with ASD were selected from Jiaxing Sunlight Rehabilitation Kindergarten, and divided into prelinguistic group (n = 23) and linguistic group (n = 21) according to the language function. The initiation-requested skills, and types and frequency of initiation-requested behaviors were observed under the novel initiation model and the conventional initiation model. ResultsBoth the groups scored higher in the novel initiation model than in the conventional initiation model for initiation-requested skills (|t| > 2.794, P < 0.05) and types of initiation-requested behaviors (|t| > 3.697, P < 0.01), and it increased for the frequency of the use of two- and three-behavioral initiation of requests (χ² > 7.986, P < 0.05). ConclusionThe novel initiation model can improve initiation request skills in children with ASD.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective To explore the relationship between lipid metabolism and the risk of proliferative retinopathy(PDR)in patients with peripheral diabetic retinopathy(DR).Methods A total of 276 patients with type 2 diabetes mellitus(T2DM)who visited our hospital from May 2022 to July 2023 were selected and divided into the simple T2DM group(n=164)and the combined DR(DR)group(n=112).The DR group was further divided into the non-proliferative retinopathy(NPDR)subgroup(n=58)and the PDR subgroup(n=54)based on the severity of DR.Spearman correlation analysis was used to analyze the relationship between lipid metabolism indicators and PDR,and Logistic regression analysis was used to analyze the influencing factors of PDR.Results In the DR group,DM duration,the utilization rate of insulin(Ins),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),glycated hemoglobin(HbA1c),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),Leptin,TG/high-density lipoprotein cholesterol(HDL-C),residual cholesterol(RC),serum creatinine(Scr),and serum uric acid(SUA)were higher than those in the T2DM group(P<0.05),while fasting C-peptide(FC-P),HDL-C and adiponectin(APN)were lower than those in the T2DM group(P<0.05).The levels of SBP,HbA1c,TC,TG,LDL-C,Leptin,TG/HDL-C,RC,Scr and SUA in the PDR subgroup were higher than those in the NPDR subgroup(P<0.05),while FC-P,HDL-C and APN were lower than those in the NPDR subgroup(P<0.05).Spearman correlation analysis showed that PDR was positively correlated with the levels of TG/HDL,RC,and Leptin(r=0.331,0.264,0.358,P<0.05),and negatively correlated with APN(r=-0.174,P<0.05).Logistic regression analysis showed that TG/HDL-C(OR 2.067,95%CI 1.827～2.643),RC(OR 1.538,95%CI 1.336～2.372),Leptin(OR 1.673,95%CI 1.361～2.474),APN(OR 0.674,95%CI 0.231～0.865),and FC-P(OR 0.147,95%CI 0.067～0.887)were the influencing factors for the progression of NPDR to PDR.Conclusions Lipid metabolism is closely related to the progression from DR to PDR.Clinically,lipid metabolism monitoring of DR patients should be done well to improve prognosis.

Nutrition dietary prescription (NDP) refers to quantified recipes or dietary plans that are developed and implemented by trained physicians, clinical dietitians, or registered dietitians to target the main issues faced by individual chronic disease patients based on nutritional screening, nutritional assessment, diagnosis of malnutrition, and comprehensive evaluation. As an important part of nutritional management of chronic diseases, NDP is recommended to be implemented with exercise prescriptions and traditional Chinese medicine (TCM) food therapies to improve the nutritional status and clinical outcomes of patients with chronic diseases, thereby enhancing their quality of life and reducing medical costs.

Objective To investigate the correlation between seminal plasma oxidation-reduction potential(ORP)and normalized ORP(nORP)with sperm DNA fragmentation index(DFI),high DNA staining(HDS),and motility parameters,and to explore whether these parameters can be used as biomarkers for evaluating male fertility potential.Methods A total of 309 men who attended the andrology clinic at the Department of Reproductive Medicine,General Hospital of Northern Theater Command,between October 2023 and December 2023,were selected in this study.We analyzed the correlation between seminal plasma ORP and nORP and parameters such as DFI using the electrode method,HDS,age,days of abstinence,semen volume,total sperm count,sperm concentration,sperm motility(forward motile sperm count,forward motile sperm percentage,non-forward sperm count,non-forward sperm percentage,immotile sperm count,immotile sperm percentage,and sperm motility rate),and motility indices(curvilinear velocity[VCL],straight-line velocity[VSL],average velocity[VAP],linear index[LIN],straightness index[STR],and wobble coefficient[WOB]).The nORP results were divided into three groups and analyzed in relation to each of the parameters mentioned above.A generalized linear regression model was used to assess the relationship between nORP and HDS,with smooth curve fitting performed to visualize this relationship.Results Pearson and Spearman correlation analyses revealed that both ORP and nORP were positively correlated with semen volume,percentage of immotile sperm,and DFI,but negatively correlated with forward motile sperm count,percentage of forward motile sperm,sperm motility rate,VSL,and VAP(P＜0.05).Additionally,ORP was positively correlated with abstinence days and immotile sperm count(P＜0.05)and negatively correlated with LIN,STR,and WOB(P＜0.05).However,nORP was positively correlated with HDS(P＜0.05),and negatively correlated with total sperm count,sperm concentration,non-forward sperm count,non-forward sperm percentage,immotile sperm count,and VCL(P＜0.05).The nORP group showed significant differences in semen volume,total sperm count,sperm concentration,forward motile sperm count,forward motile sperm percentage,non-forward sperm count,non-forward sperm percentage,immotile sperm count,immotile sperm percentage,sperm motility rate,VCL,VSL,VAP,DFI,and HDS(P＜0.05).A smooth curve fitting of nORP and HDS,adjusted for age and abstinence days,demonstrated a linear upward trend in nORP as HDS increased.Conclusion Both ORP and nORP are associated with sperm DFI and key motility parameters.Moreover,nORP is closely related to HDS,which reflects sperm maturity,offering a more comprehensive indicator of semen quality.Thus,nORP can be utilized as a biomarker for assessing male fertility potential.

Objective To investigate the effect and mechanism of melatonin in alleviating hypoxia-induced apoptosis in ovarian gra-nulosa cells.Methods Rat ovarian granulosa cells were isolated and divided into normoxic,hypoxic,and melatonin groups.Hypoxia-induced injury models were established in the hypoxic and melatonin groups,and granulosa cells in the melatonin group were treated with melatonin.A total of 24 rats were randomized into the control,model,and intervention groups(n=8 per group).Rat models of declining ovarian function induced by long-term hypoxia were established in the model and intervention groups.The rats in the intervention group were intraperitoneally injected with melatonin.Cell proliferation was measured using a CCK-8 assay,and lactate secretion and HIF-1αprotein with a specific kit,respectively.The levels of estradiol and progesterone in the cell supernatant and rat serum were detected using ELISA.Granulosa cell apoptosis was detected by flow cytometry,ovarian morphology by HE staining,and Bax and caspase-3 expression by Western blotting.Results Compared with the normoxic group,the hypoxic group exhibited decreased granulosa cell proliferation,increased apoptosis,elevated lactate and HIF-1α levels,and reduced estradiol and progesterone levels(P＜0.05).Compared with hypoxic group,these changes were significantly reversed in the molatonin group(P＜0.05).Compared with the control group,the model group showed increased lactate,HIF-1α,Bax,and caspase-3 levels,decreased estradiol and progesterone levels,and reduced follicles.Compared with the model group,all the indicators were ameliorated in the intervention group(P＜0.05).Conclusion Melatonin alleviated hypoxia-induced granulosa cell apoptosis and promoted the recovery of ovarian function.

Objective To explore the impact of the interaction between fasting plasma glucose(FPG)and serum uric acid(SUA)on peripheral diabetic retinopathy(DR).Methods Peripheral DR patients(n=188)admitted to our hospital from July 2022 to June 2023 were selected as the research subjects and divided into mild to moderate non-proliferative diabetic retinopathy(NPDR)group(M-NPDR,n=114)and severe NPDR(S-NPDR,n=74)group.DM patients without diabetic retinopathy admitted to our hospital during the same period were set as the control(T2DM,n=100)group.The general data and biochemical indicators were compared among the three groups.Logistic regression was used to analyze the relationship between FPG and SUA and the severity of DR.The interaction between FPG and SUA was evaluated.A nomogram model was established to predict the occurrence of severe NPDR.Results The DM duration,best corrected visual acuity converted to logarithm of minimum resolution angles(logMAR BCVA),FPG,SUA and urinary albumin/creatinine ratio(UACR)in M-NPDR and S-NPDR groups were higher than those in T2DM group(P＜0.05).Subfoveal choroidal thickness(SFCT),albumin(ALB)and free triiodothyronine(FT3)were lower than those in the T2DM group(P＜0.05).BUN in S-NPDR group was higher than that in T2DM group(P＜0.05).The DM duration,logMAR BCVA,FPG,TC,TG and SUA in S-NPDR group were higher than those in M-NPDR group(P＜0.05),and SFCT was lower than that in M-NPDR group(P＜0.05).SFCT,FPG,ALB,SUA,and(UACR)were independent influencing factors of severe NPDR(P＜0.05).The column chart model predicted the probability of severe NPDR occurrence,with area under curve of 0.919 and 0.910 before and after validation,and the average absolute error of the calibration curve 0.013,which can be used as risk tool to predict DR severity of T2DM patients.Conclusions FPG and SUA are risk factors affecting the severity of DR and there is an interaction.Early warning of risk factors based on the nomogram model is helpful to improve the prognosis of patients with peripheral DR.