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 observe the antidepressant effect of Chaihu Shugansan combined with ferulic acid on the rat model of chronic unpredictable mild stress （CUMS） and explore the mechanism from the histomorphology of frontal cortex， expression of key molecules in the brain-derived neurotrophic factor （BDNF）/tyrosine kinase receptor B （TrkB） signaling pathway， and changes in monoamine neurotransmitter levels. MethodsSixty adult male SD rats were randomized into six groups （n=10）： blank control， depression model， Chaihu Shugansan （3.3 g·kg^-1·d^-1）， ferulic acid （50 mg·kg^-1·d^-1）， Chaihu Shugansan （3.3 g·kg^-1·d^-1） + ferulic acid （50 mg·kg^-1·d^-1）， and fluoxetine （2.1 mg·kg^-1·d^-1）. Rats in other groups except the blank control group were subjected to a mild chronic unpredictable stress stimulus every day. Seven stimuli were used， including fasting with free access to water for 24 h， water deprivation with free access to food for 24 h， wetting the bedding with water in the cage， restraint for 3 h， tail clamping for 1 min， swimming in ice water at 4 ℃， and day and night reversal. Each stimulus was used 1 to 3 times， and the modeling lasted for a total of 21 days. At the same time of stimulation， rats in each medication group were treated with corresponding agents by gavage， while those in the blank control group and the depression model group received equal volumes of normal saline by gavage. The open field test， sucrose preference test， and forced swimming test were conducted before and after modeling. The rats were anesthetized by intraperitoneal injection of 3% pentobarbital sodium， and the frontal cortex was isolated on ice. The mRNA and protein levels of BDNF， TrkB， and cyclic adenosine monophosphate-responsive element-binding protein （CREB） in the frontal cortex were determined by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. The levels of monoamine neurotransmitters 5-hydroxytryptamine （5-HT）， dopamine （DA）， and norepinephrine （NE） in the frontal cortex were determined by enzyme-linked immunosorbent assay. Light microscopy was employed to observe the histopathological changes in the frontal cortex. ResultsCompared with the blank control group， the depression model group showed reduced body mass （P<0.05， P<0.01）， decreased number of crossings and rearings in the open field test and sucrose preference （P<0.01）， prolonged time of immobility in the forced swimming test （P<0.01）， reduced neuronal cells， increased necrotic cells， and darkening cell staining in the frontal cortex， down-regulated mRNA and protein levels of BDNF， TrkB， CREB， and lowered levels of 5-HT， NE， and DA in the frontal cortex （P<0.01）. Compared with the depression model group， each intervention group showed improved general state， increased body mass （P<0.05）， increased number of crossings （P<0.05）， shortened immobility time in the forced swimming test （P<0.01）， increased neuronal cells， reduced necrotic cells， and lightened cellular staining in the frontal cortex， up-regulated mRNA and protein levels of BDNF， TrkB and CREB， and elevated levels of 5-HT， NE， and DA in the frontal cortex （P<0.01）. Moreover， the Chaihu Shugansan + ferulic acid group outperformed the Chaihu Shugansan group and the ferulic acid group in increasing the body mass and the 5-HT content in the frontal cortex （P<0.05）. The combination group outperformed the Chaihu Shugansan group regarding the number of rearings and up-regulation in the mRNA level of BDNF in the frontal cortex （P<0.05）， and it was superior to the ferulic acid group in terms of shortening the immobility time in the forced swimming test， up-regulating the mRNA levels of BDNF， TrkB， and CREB and the protein levels of BDNF and CREB in the frontal cortex， and increasing the DA content in the frontal cortex （P<0.05）. ConclusionChaihu Shugansan combined with ferulic acid can exert antidepressant effect on the rat model of CUMS by regulating the BDNF/TrkB signaling pathway and monoamine neurotransmitter content in the frontal cortex. Moreover， the antidepressant effect of Chaihu Shugansan combined with ferulic acid was more significant than that of Chaihu Shugansan and ferulic acid used alone.

ObjectiveTo investigate the effect and possible mechanism of prolyl endopeptidase （PREP） on a mouse model of non-alcoholic steatohepatitis （NASH） induced by high-fat diet. MethodsA total of 18 healthy male C57BL/6J mice， aged 6‍ ‍—‍ ‍8 weeks， were randomly divided into normal control group， NASH group， and NASH+rosmarinic acid （RA） group， with 6 mice in each group. The mice in the control group were fed with normal diet for 16 weeks， and those in the NASH group and the NASH+RA group were fed with high-fat diet for 16 weeks； the mice in the NASH+RA group were given the PREP inhibitor RA by gavage since week 9 at a dose of 100 mg/kg， once a day for 8 weeks. The mice were sacrificed after modeling and intervention， and each group of mice was observed in terms of serum inflammatory indicators， the concentration of triglyceride in the liver， and the changes in liver lipids/inflammation/liver fibrosis； NAFLD activity score （NAS） was calculated. Western blot and quantitative real-time PCR were used to measure the protein and mRNA expression levels of PREP， peroxisome proliferator-activated receptor-γ （PPAR-γ）， fibroblast growth factor 21 （FGF21）， and silent information regulator 1 （SIRT1） in liver tissue. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， while the least significant difference t-test and the Dunnett’s-T3 test were used for further comparison between two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups. ResultsCompared with the NASH group， the NASH+RA group had significant reductions in the serum levels of interleukin-6， tumor necrosis factor-α， and triglyceride （all P<0.05）， as well as significant improvements in hepatic steatosis， hepatocyte edema， inflammatory cell infiltration， and liver tissue lesion. The NASH+RA group had a significant reduction in NAS compared with the NASH group （P<0.05）， and the NASH group had an increase in perivascular collagen fiber with occasional fiber bridging， while the NASH+RA group had a slight reduction in perivascular collagen fiber compared with the NASH group. Compared with the normal control group， the NASH group had a significant increase in collagen area percentage in the liver （P<0.05）， while the NASH+RA group had no significant reduction in collagen area percentage compared with the NASH group. Compared with the NASH group， the NASH+RA group had significant increases in the relative protein expression levels of PPAR-γ， FGF21， and SIRT1 （all P<0.05） and a significant reduction in the relative protein expression level of PREP （P<0.05）. Compared with the NASH group， the NASH+RA group had significant increases in the relative mRNA expression levels of PPAR-γ， FGF21， and SIRT1 （P<0.05） and a significant reduction in the relative mRNA expression level of PREP （P<0.05）. ConclusionPREP reduces the level of inflammation and improves NASH in mice by regulating the PPAR-γ/FGF21/SIRT1 signaling pathway.

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 investigate the risk factors affecting live birth outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) and to establish a predictive model. Methods:A retrospective case-control study was conducted by collecting data from 563 patients with PCOS who were treated at the Reproductive Medicine Department of the General Hospital of Northern Theater Command between June 2018 and January 2023. Patients were divided into live birth ( n=341) and non-live birth ( n=222) groups based on pregnancy outcomes. Univariate and multivariate logistic regression analyses were performed to identify risk factors, followed by construction of a nomogram prediction model based on values with P<0.05 in multiple regression analysis. The model's predictive performance was evaluated using receiver operating characteristic curve analysis, calibration curves, Hosmer-Lemeshow (H-L) goodness-of-fit test, and decision curve analysis. Results:1) Univariate analysis revealed that there were statistically significant differences in age, body mass index (BMI), insulin level, the number of high-quality embryos, and the rate of high-quality embryos between the two groups (all P<0.05). 2) After adjusting for confounding factors, the results of multivariate logistic regression analysis on variables associated with live birth outcomes in the live birth group showed that: age ( OR=1.151, 95% CI: 1.061-1.249, P=0.001), body mass index ( OR=1.141, 95% CI: 1.074-1.214, P<0.001), and insulin level ( OR=1.206, 95% CI: 1.149-1.266, P<0.001) were independent risk factors for live birth outcome; top-quality embryo rate ( OR=0.101, 95% CI: 0.033-0.310, P<0.001) was a protective factor; and the number of top-quality embryos ( OR=0.949, 95% CI: 0.887-1.014, P=0.104) showed no statistically significant association with live birth outcome. 3) A predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The area under the curve (AUC) values for predicting the live-birth outcome based on female age, BMI, the rate of high-quality embryos, and insulin level were 0.581, 0.747, 0.725, and 0.813, respectively. The combined model of these four factors had an AUC value of 0.846 for predicting the live-birth outcome. 4) A nomogram predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The slope of the model's calibration curve was close to 1, and the H-L test yielded a P>0.05, indicating a high consistency between predicted and actual events. The decision analysis curve confirmed the clinical practicality of the predictive model. Conclusion:Age, BMI and insulin level are independent risk factors for live birth outcomes in PCOS patients undergoing IVF/ICSI-ET, while the high-quality embryo rate serves as a protective factor. The established predictive model demonstrates excellent performance and may facilitate clinical decision-making.

BACKGROUND:High-intensity resistance training effectively improves muscle strength,but with a high risk of arteriosclerosis;high-intensity resistance training combined with aerobic exercise effectively reduces the level of arteriosclerosis;low-intensity resistance combined with blood flow restriction training does not require high load strength to stimulate muscles,which may be a scientific training method to improve muscle strength and maintain arterial elasticity.OBJECTIVE:To explore the effects of 12 weeks of low-intensity resistance training combined with blood flow restriction training on body composition,muscle strength,and arterial elasticity in young people,thereby providing theoretical support for the development of personalized training programs.METHODS:Fifty-five college students were randomly recruited and divided by drawing lots into high-intensity resistance training group,high-intensity resistance training combined with aerobic exercise group,and low-intensity resistance training combined with blood flow restriction training group. All participants were subjected to 12 weeks of high-intensity resistance training,high-intensity resistance training combined with aerobic exercise,or low-intensity resistance training combined with blood flow restriction training,and their body composition,muscle strength,and arterial elasticity were tested after training. RESULTS AND CONCLUSION:After 12 weeks of training intervention,the lean body mass of the high-intensity resistance training group and the low-intensity resistance training combined with blood flow restriction training group significantly increased (P<0.05). The one-repetition maximum and knee isokinetic muscle strength significantly increased in all the three groups (P<0.05). The arterial elasticity of the high-intensity resistance training combined with aerobic exercise group and the low-intensity resistance training combined with blood flow restriction training group significantly improved (P<0.05). These findings indicate that 12 weeks of high-intensity resistance training and low-intensity resistance training combined with blood flow restriction training significantly improve body composition;all the three training programs can increase muscle strength;12 weeks of high-intensity resistance training combined with aerobic exercise and low-intensity resistance training combined with blood flow restriction training both improve arterial elasticity,and the effect of low-intensity resistance training combined with blood flow restriction training is superior to that of high-intensity resistance training combined with aerobic exercise. Therefore,it is recommended that low-intensity resistance training combined with blood flow restriction training be used as the preferred training method to improve arterial elasticity,thus reducing the risk of arteriosclerosis.

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.