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 investigate the clinical efficacy of Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase in the treatment of diabetic retinopathy. Methods:This study was a prospective research. A total of 90 patients with diabetic retinopathy treated at The People's Hospital of Liaoning Province from September 2021 to March 2024 were included in this study. The patients were randomly assigned to an observation group and a control group, with 45 patients in each group, using the random number table method. The control group received treatment with injectable pancreatic kallidinogenase, while the observation group underwent treatment with Di'ao Xinxuekang Capsules in addition to injectable pancreatic kallidinogenase. Both groups were treated for 14 days. The clinical efficacy, changes in visual acuity after treatment compared with before treatment, ocular hemodynamic indicators (peak systolic velocity and resistance index), and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [90.91% (40/45) vs. 73.33% (33/45), χ2 = 8.61, P<0.05]. Before treatment, there were no significant differences between the two groups regarding visual acuity values, retinal thickness, and ocular hemodynamic parameters ( t = 0.11, 0.05, 0.47, 1.08, all P>0.05). After 14 days of treatment, the visual acuity in the observation group was significantly higher than that in the control group [(1.06 ± 0.11) vs. (0.81 ± 0.06), t = 12.62, P<0.001]. The peak systolic velocity in the observation group was significantly greater than that in the control group [(31.85 ± 1.92) cm/s vs. (27.01 ± 1.33) cm/s, t = 8.01, P<0.001]. The retinal thickness in the observation group was significantly lower than that in the control group [(311.5 ± 45.2) μm vs. (350.3 ± 59.3) μm, t = -3.49, P<0.001]. The resistance index in the observation group was significantly lower than that in the control group [(0.59 ± 0.02) vs. (0.68 ± 0.04), t = -12.57, P<0.001]. There was no significant difference in the incidence of adverse reactions between the observation and control groups [8.89% (4/45) vs. 6.67% (3/45), χ2 = 0.16, P>0.05]. Conclusions:Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase for the treatment of diabetic retinopathy can effectively enhance clinical efficacy, improve patients' visual acuity and ocular hemodynamic indicators, and is considered safe.

Objective:To investigate the clinical efficacy of Zhibitai capsules combined with liraglutide in the treatment of type 2 diabetes mellitus (T2MD) complicated by metabolic-associated fatty liver disease (MAFLD). Methods:This study used a prospective design. A total of 92 patients with T2DM complicated by MAFLD who were admitted to The People's Hospital of Liaoning Province from September 2023 to September 2024 were included in this study. They were randomly divided into an observation group and a control group, with 46 patients in each group. Both groups received lifestyle intervention and standard antidiabetic treatment. The control group received subcutaneous injections of liraglutide, while the observation group was treated with liraglutide combined with Zhibitai capsules. All patients were treated for 3 months. Blood glucose levels, glycated hemoglobin, blood lipid levels, liver function, and hemodynamic parameters were compared between the two groups both before and after treatment. The controlled attenuation parameter of liver fat was measured using Fibro Touch. Results:After treatment, there were no statistically significant differences in fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels between the two groups (all P > 0.05). The high-density lipoprotein cholesterol level in the observation group was significantly higher than that in the control group [(1.31 ± 0.40) mmol/L vs. (0.90 ± 0.30) mmol/L, t = -5.56, P < 0.001]. The levels of total cholesterol [(3.70 ± 0.80) mmol/L vs. (4.40 ± 0.90) mmol/L], triglycerides [(1.50 ± 0.40) mmol/L vs. (2.60 ± 0.50) mmol/L], and low-density lipoprotein cholesterol [(1.80 ± 0.50) mmol/L vs. (2.60 ± 0.60) mmol/L] in the observation group were significantly lower than those in the control group ( t = 3.94, 11.65, 6.39, all P < 0.001). The controlled attenuation parameter of liver fat in the observation group was significantly lower than that in the control group [(249.20 ± 7.60) dB/m vs. (264.70 ± 8.70) dB/m, t = 9.10, P < 0.001]. The level of total bilirubin in the observation group was significantly higher than that in the control group [(16.40 ± 1.50) μmol/L vs. (15.00 ± 1.40) μmol/L, t = -4.63, P < 0.05], while the levels of other liver function indicators in the observation group were significantly lower than those in the control group ( t = 4.83, 9.57, 3.66, all P < 0.001). After treatment, whole blood viscosity at high shear rates, whole blood viscosity at lower shear rates, plasma viscosity, and platelet aggregation levels were all significantly lower in the observation group compared with the control group ( t = 2.13, 2.62, 2.97, 6.15, 4.00, all P < 0.05). Conclusions:Zhibitai capsules combined with liraglutide can improve blood glucose levels, lipid profiles, and liver function, while also decreasing blood viscosity in patients with T2MD complicated by MAFLD.

Objective:To investigate the clinical efficacy of Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase in the treatment of diabetic retinopathy. Methods:This study was a prospective research. A total of 90 patients with diabetic retinopathy treated at The People's Hospital of Liaoning Province from September 2021 to March 2024 were included in this study. The patients were randomly assigned to an observation group and a control group, with 45 patients in each group, using the random number table method. The control group received treatment with injectable pancreatic kallidinogenase, while the observation group underwent treatment with Di'ao Xinxuekang Capsules in addition to injectable pancreatic kallidinogenase. Both groups were treated for 14 days. The clinical efficacy, changes in visual acuity after treatment compared with before treatment, ocular hemodynamic indicators (peak systolic velocity and resistance index), and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [90.91% (40/45) vs. 73.33% (33/45), χ2 = 8.61, P<0.05]. Before treatment, there were no significant differences between the two groups regarding visual acuity values, retinal thickness, and ocular hemodynamic parameters ( t = 0.11, 0.05, 0.47, 1.08, all P>0.05). After 14 days of treatment, the visual acuity in the observation group was significantly higher than that in the control group [(1.06 ± 0.11) vs. (0.81 ± 0.06), t = 12.62, P<0.001]. The peak systolic velocity in the observation group was significantly greater than that in the control group [(31.85 ± 1.92) cm/s vs. (27.01 ± 1.33) cm/s, t = 8.01, P<0.001]. The retinal thickness in the observation group was significantly lower than that in the control group [(311.5 ± 45.2) μm vs. (350.3 ± 59.3) μm, t = -3.49, P<0.001]. The resistance index in the observation group was significantly lower than that in the control group [(0.59 ± 0.02) vs. (0.68 ± 0.04), t = -12.57, P<0.001]. There was no significant difference in the incidence of adverse reactions between the observation and control groups [8.89% (4/45) vs. 6.67% (3/45), χ2 = 0.16, P>0.05]. Conclusions:Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase for the treatment of diabetic retinopathy can effectively enhance clinical efficacy, improve patients' visual acuity and ocular hemodynamic indicators, and is considered safe.

Objective:To investigate the clinical efficacy of Zhibitai capsules combined with liraglutide in the treatment of type 2 diabetes mellitus (T2MD) complicated by metabolic-associated fatty liver disease (MAFLD). Methods:This study used a prospective design. A total of 92 patients with T2DM complicated by MAFLD who were admitted to The People's Hospital of Liaoning Province from September 2023 to September 2024 were included in this study. They were randomly divided into an observation group and a control group, with 46 patients in each group. Both groups received lifestyle intervention and standard antidiabetic treatment. The control group received subcutaneous injections of liraglutide, while the observation group was treated with liraglutide combined with Zhibitai capsules. All patients were treated for 3 months. Blood glucose levels, glycated hemoglobin, blood lipid levels, liver function, and hemodynamic parameters were compared between the two groups both before and after treatment. The controlled attenuation parameter of liver fat was measured using Fibro Touch. Results:After treatment, there were no statistically significant differences in fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels between the two groups (all P > 0.05). The high-density lipoprotein cholesterol level in the observation group was significantly higher than that in the control group [(1.31 ± 0.40) mmol/L vs. (0.90 ± 0.30) mmol/L, t = -5.56, P < 0.001]. The levels of total cholesterol [(3.70 ± 0.80) mmol/L vs. (4.40 ± 0.90) mmol/L], triglycerides [(1.50 ± 0.40) mmol/L vs. (2.60 ± 0.50) mmol/L], and low-density lipoprotein cholesterol [(1.80 ± 0.50) mmol/L vs. (2.60 ± 0.60) mmol/L] in the observation group were significantly lower than those in the control group ( t = 3.94, 11.65, 6.39, all P < 0.001). The controlled attenuation parameter of liver fat in the observation group was significantly lower than that in the control group [(249.20 ± 7.60) dB/m vs. (264.70 ± 8.70) dB/m, t = 9.10, P < 0.001]. The level of total bilirubin in the observation group was significantly higher than that in the control group [(16.40 ± 1.50) μmol/L vs. (15.00 ± 1.40) μmol/L, t = -4.63, P < 0.05], while the levels of other liver function indicators in the observation group were significantly lower than those in the control group ( t = 4.83, 9.57, 3.66, all P < 0.001). After treatment, whole blood viscosity at high shear rates, whole blood viscosity at lower shear rates, plasma viscosity, and platelet aggregation levels were all significantly lower in the observation group compared with the control group ( t = 2.13, 2.62, 2.97, 6.15, 4.00, all P < 0.05). Conclusions:Zhibitai capsules combined with liraglutide can improve blood glucose levels, lipid profiles, and liver function, while also decreasing blood viscosity in patients with T2MD complicated by MAFLD.

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 explore the causal relationship between social activity and depressive symptoms in the elderly, and to provide a reference for preventing and interventing depressive symptoms in the elderly.Methods:Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) program, involving 3 164 elderly individuals aged≥60 years with data collected in two measurements, in 2015 (T1) and 2018 (T2). The sample included 1 240 males and 1 924 females aged (71±7) years. Social activities were assessed by constructing a social activity index from the 11 social activities included in the CHARLS questionnaire and the frequency of their activities. The depressive symptoms were assessed using the short version of the Center for Epidemiological Studies Depression Scale (the 10-item Center for Epidemiological Studies Depression Scale, CESD-10). A mixed-design ANOVA was used to explore the trends in social activity and depressive symptoms over time and across genders in the elderly adults. Pearson correlation analysis was used to investigate whether social activity and depressive symptoms in the elderly met the criteria for simultaneous and sequential correlations, followed by a cross-lagged model to analyze the causal temporal or mutual prediction between social activeness and depressive symptoms over a 3-year intervals.Results:The social activity of elderly men at T2 was significantly lower than at T1 ( F=21.00, P<0.001), while no significant difference observed in elderly women ( F=0.31, P<0.001). At both T1 and T2, elderly men scored higher in social activity than elderly women [T1: 2.93±2.98 vs 2.55±2.65,T2: 2.28±2.49 vs 2.24±2.43); F=43.60, 11.24, both P<0.01]. Depressive symptoms at T2 were higher than at T1 for both elderly men and elderly women ((male: 1.90±6.10 vs 21.52±6.08, female: 23.84±6.54 vs 23.07±6.44); F=5.20, 32.77, both P<0.05). Elderly men scored lower than elderly women on depression symptoms at both T1 and T2 (T1: F=45.74, P<0.001; T2: F=69.96, P<0.001). Pearson correlation analysis showed a negative correlation between social activity and depressive symptoms at both measurement points (T1: r=-0.329, P<0.01; T2: r=-0.343, P<0.01), and a positive correlation across T1 and T2 ( r=0.391, 0.573; both P<0.01), meeting the criteria for simultaneous and sequential correlations, and supporting the basic assumptions of cross-lagged design. Cross-lagged analysis revealed that T1 social activity negatively predicted T2 depressive symptoms (β=-0.128, P<0.001), and T1 depressive symptoms negatively predicted T2 social activity (β=-0.202, P<0.001). Conclusion:There is a bidirectional predictive relationship between social activity and depression symptoms in the elderly. Depression symptoms lead to a decrease in social activity, and a decrease in social activity predicts an exacerbation of depression in the elderly.

Objective:To explore the causal relationship between social activity and depressive symptoms in the elderly, and to provide a reference for preventing and interventing depressive symptoms in the elderly.Methods:Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) program, involving 3 164 elderly individuals aged≥60 years with data collected in two measurements, in 2015 (T1) and 2018 (T2). The sample included 1 240 males and 1 924 females aged (71±7) years. Social activities were assessed by constructing a social activity index from the 11 social activities included in the CHARLS questionnaire and the frequency of their activities. The depressive symptoms were assessed using the short version of the Center for Epidemiological Studies Depression Scale (the 10-item Center for Epidemiological Studies Depression Scale, CESD-10). A mixed-design ANOVA was used to explore the trends in social activity and depressive symptoms over time and across genders in the elderly adults. Pearson correlation analysis was used to investigate whether social activity and depressive symptoms in the elderly met the criteria for simultaneous and sequential correlations, followed by a cross-lagged model to analyze the causal temporal or mutual prediction between social activeness and depressive symptoms over a 3-year intervals.Results:The social activity of elderly men at T2 was significantly lower than at T1 ( F=21.00, P<0.001), while no significant difference observed in elderly women ( F=0.31, P<0.001). At both T1 and T2, elderly men scored higher in social activity than elderly women [T1: 2.93±2.98 vs 2.55±2.65,T2: 2.28±2.49 vs 2.24±2.43); F=43.60, 11.24, both P<0.01]. Depressive symptoms at T2 were higher than at T1 for both elderly men and elderly women ((male: 1.90±6.10 vs 21.52±6.08, female: 23.84±6.54 vs 23.07±6.44); F=5.20, 32.77, both P<0.05). Elderly men scored lower than elderly women on depression symptoms at both T1 and T2 (T1: F=45.74, P<0.001; T2: F=69.96, P<0.001). Pearson correlation analysis showed a negative correlation between social activity and depressive symptoms at both measurement points (T1: r=-0.329, P<0.01; T2: r=-0.343, P<0.01), and a positive correlation across T1 and T2 ( r=0.391, 0.573; both P<0.01), meeting the criteria for simultaneous and sequential correlations, and supporting the basic assumptions of cross-lagged design. Cross-lagged analysis revealed that T1 social activity negatively predicted T2 depressive symptoms (β=-0.128, P<0.001), and T1 depressive symptoms negatively predicted T2 social activity (β=-0.202, P<0.001). Conclusion:There is a bidirectional predictive relationship between social activity and depression symptoms in the elderly. Depression symptoms lead to a decrease in social activity, and a decrease in social activity predicts an exacerbation of depression in the elderly.

Objective:To investigate the clinical effect of free superficial circumflex iliac artery flap combined with anterolateral thigh flap in repairing large skin defect of the hand.Methods:A retrospective case series study was conducted to analyze the clinical data of 9 patients with large skin defect of the hand admitted to Ningbo No.6 Hospital from January 2016 to December 2019，including 7 males and 2 females，aged 31-63 years［（45.3±5.6）years］. The area of skin defect reanged from 20 cm×15 cm to 25 cm×20 cm. One side of the superficial circumflex iliac artery flap and the contralateral anterolateral thigh flap were used for repair. Both recipient and donor sites were sutured at the first stage. The ilioinguinal region and thigh donor region were sutured directly. The area of superficial circumflex iliac artery flap was from 19 cm×6 cm to 23 cm ×10 cm and that of anterolateral thigh flap was 19 cm×9 cm to 23 cm×8 cm. The flap survival，healing of donor and recipient area and complications were observed. At 1，6 and 12 months after operation，the function of the flap was evaluated by the late functional evaluation criteria of the flap，hand function by the upper limb functional evaluation criteria of the Chinese Medical Association，and scar condition of the donor site by Vancouver Scar Scale（VVS）. At the last follow-up，the color，elasticity，appearance and scar of the donor site were observed.Results:All patients were followed up for 6-18 months［（12.5±2.3）months］. All flaps survived successfully. All patients achieved donor-site healing at the first stage，except that one patient experienced incision dehiscence in the thigh donor site after operation and healed after the second stage suture. The texture and appearance of the flaps were good. The flap in 5 patients was obviously bloated. Therefore，the secondary skin flap repair was selected，and the appearance was significantly improved after operation. Scores for function of the flap and the hand were improved over time（ P<0.05）. At 12 months after operation，the function of the flap was excellent in 3 patients，good in 4 and fair in 2，with the excellent and good rate of 78%；the result of hand function was excellent in 3 patients，good in 3 and fair in 3，with the excellent and good rate of 67%. The VVS score of the donor site decreased from（9.7±1.3）points at postoperative 1 month to（5.7±0.9）points at postoperative 6 months and（3.4±0.8）points at postoperative 12 months（ P<0.05）. At the latest follow-up，the color and elasticity of the flap was similar to that of the surrounding skin tissue，only with slight bloating；the scar of the donor site was small. Conclusions:The free superficial circumflex iliac artery flap combined with anterolateral thigh flap can cover large skin defect of the hand at one time，with good appearance and texture of the flap. The appearance and function of the wounded hand are good after operation，leaving only linear scar in the donor site.

Objective To investigate the effect of clotrimazole on apoptosis of hepatic cells after ischemia-reperfusion injury and its mechanism. Methods Hepatic ischemia-reperfusion rat model was established. Thirty-two male Sprague-Dawley rats were randomly allocated into sham-operated group, model control group, low dose clotrimazole group and high dose clotrimazole group. Apoptosis in hepatic tissue was assessed by TUNEL method. Protein expression levels of CYP3A1,Bcl-2,Bax and PARP were measured by Western blotting. Results As compared with model control group, the apoptosis rate, tissue injury,activity of plasma enzymes and the Bax/Bcl-2 expression ratio were reduced in low and high dose clotrimazole groups. The apoptotic index in both clotrimazole-treated groups was lower than that of model control group with statistically significant difference. CYP3A1 expression was significantly induced by clotrimazole compared to the sham-operated group. Conclusion Clotrimazole may inhibit apoptosis of hepatic cells by up-regulating Bcl-2 and down-regulating Bax, thus produce a protective effect on hepatic ischemia-reperfusion injury and it is also related to the inhibition of PARP shear.