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.

This article focuses on the deepening and innovation of grassroots party building work in public hospitals,tak-ing Sijing Hospital in Songjiang District,Shanghai as a case study.It explores how public hospitals can improve service quality and promote high-quality development through party building work in the new era.By analyzing the main problems faced by party building work,this article proposes practical paths for innovative party building work,including establishing a party building grid management organizational framework,formulating and improving party building management standards and systems,standardi-zing party building project processes,and strengthening party building assessment and supervision.Through the deepening and innovation of party building work,the integration of party building work and hospital business is achieved,thereby enhancing the overall service capacity and management level of the hospital,cultivating high-quality medical and health personnel,and provi-ding solid political guarantees and organizational support for the sustainable development of public hospitals.

This article focuses on the deepening and innovation of grassroots party building work in public hospitals,tak-ing Sijing Hospital in Songjiang District,Shanghai as a case study.It explores how public hospitals can improve service quality and promote high-quality development through party building work in the new era.By analyzing the main problems faced by party building work,this article proposes practical paths for innovative party building work,including establishing a party building grid management organizational framework,formulating and improving party building management standards and systems,standardi-zing party building project processes,and strengthening party building assessment and supervision.Through the deepening and innovation of party building work,the integration of party building work and hospital business is achieved,thereby enhancing the overall service capacity and management level of the hospital,cultivating high-quality medical and health personnel,and provi-ding solid political guarantees and organizational support for the sustainable development of public hospitals.

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 effect of occupational lead exposure on the relative telomere length(RTL) and mRNA expression of telomere-binding protein POT1-interacting protein 1(TPP1) in peripheral blood of workers. METHODS: A total of 303 workers exposed to lead were selected as the exposure group and 72 administrative logisticians personnel in the same factory as the control group using the simple random sampling method. Their peripheral blood samples were collected and were used to detect the blood lead level by Graphite furnace atomic absorption spectrometry. RTL and the relative expression of TPP1 mRNA by real-time quantitative polymerase chain reaction. RESULTS: The blood lead level of the exposure group was higher [Media(M): 68.2 vs 266.1 μg/L, P<0.01], the RTL was shorter(M: 0.96 vs 0.70, P<0.01), and the relative mRNA expression of TPP1 was lower(M: 0.92 vs 0.51, P<0.01) compared with the control group. Spearman correlation analysis results showed that the blood lead level were both negatively correlated with RTL [Spearman correlation coefficient(r_S) =-0.18, P<0.01], and the relative mRNA expression of TPP1(r_S=-0.19, P<0.01), while the RTL was positively correlated with the risk of RTL shortening and the relative mRNA expression of TPP1 decline was increased in lead exposure(P<0.01). CONCLUSION: Lead exposure can shorten the RTL and reduce the relative mRNA expression of TPP1 in workers. The mechanism may be that lead interferes with telomere repair process by inhibiting the mRNA expression of TPP1.

[Absract] Objective This paper was designed to reveal the new mechanism on ASI Ⅱ triggered CD4+T cells activation via regulating CD45 molecular and provide a basis for the theoretical foundation of antitumor immunotherapy of Astragalus.Methods The CD4+T cells were randomly divided into negative group,stimulated control group,ASI Ⅱ group,CD45 inhibitor group,and the combination of ASI Ⅱ and CD45 inhibitor group.Besides negative group,the cells from other groups were activated by anti-CD3/CD28 antibody.ASI Ⅱ group was treated with 10 nmol/L ASI Ⅱ,CD45 inhibitor group was treated with 0.8 μmol/L CD45 inhibitor,and the combination group were treated with 10 nmol/L ASI Ⅱ and 0.8 iμmol/L CD45 inhibitor.After 36h culture,the proliferation of CD4+T cells was detected by Ki-67 intracellular staining assay.Cytokine production of Th1 and Th2 were examined ELISA method.The proportion of surface marker (CD44 and CD25)and Th1 intracellular cytokines (IFN-γ) were detected by flow cytometry.Results Compared with stimulated group,Astragaloside Ⅱ group in CD4+Ki67+T positive proportion (5.37％ ± 0.92％ vs.1.19％ ± 0.23％),in CD4+CD25+ positive proportion (50.23％ ± 4.65 ％ vs.15.89％ ± 1.13％),in CD4+CD44+ positive proportion (33.16％ ± 6.08％ vs.15.36％ 4 1.45％),in CD4+IFN-γ+ positive proportion (1.42％ ± 0.44 ％ vs.0.38％ ± 0.06％) were significntly increased.And the secretion of IFN-γ,IL-4 and IL-2 in ASI Ⅱ group were higher than stimulated group.The anti-mouse CD45 Ab treatment markedly blocked the proliferation and Th1 cytokines production which induced by ASI Ⅱ.Furthermore,the anti-mouse CD45 Ab treatment significantly decreased the expression of surface marker (CD44 and CD25).Conclusions Activating CD45 protein tyrosine phosphatase may be involved in ASI Ⅱ triggered CD4+T cells activation.This study will provide a basis for antitumor immunotherapy of Astragalus.

Objective To detect mutations of the type Ⅱ human basic hair keratin (hHb) gene in a family of Han nationality with monilethrix.Methods Clinical data were collected from a family of Han nationality with monilethrix.Dermoscopy was performed to observe hairs of the family members,and light microscopy and scanning electron microscopy (SEM) were conducted to investigate the features of lesional hairs.Blood samples were obtained from the proband,other family members and 100 healthy controls,and DNA was extracted from these blood samples.Polymerase chain reaction (PCR) was performed to amplify the exons 1 and 7 of the hHb1,hHb3 and hHb6 genes,and DNA sequencing results were compared with their sequences in the GenBank database.Results The proband was an 8-year-old girl,whose head hairs had become fragile and easy to pull out since 2 months after birth.Skin examination showed diffuse sparsehairs,most of which were 2-cm-long broken hairs with abnormal appearance.Moniliform hairs were scattered all over the head,especially on the occipital region,and follicular keratotic papules were observed on the back of the neck.The proband was diagnosed with monilethrix.There were a total of 15 members in the 3-generation family,and 4 were diagnosed with monilethrix.The hair shafts of the 4 patients all showed typical moniliform structures.After 9-month consecutive treatment with topical minoxidil 2％ solution,the hairs of the proband turned longer and denser.A heterozygous mutation c.1237G＞A (p.E413K) was identified in the exon 7 of the hHb6 gene in the 4 patients,but not in the other family members or 100 healthy controls.Conclusion The E413K mutation of the hHb6 gene was firstly found in the patients in a Chinese Han family with monilethrix,which may be responsible for moniliform hairs.

Objective To investigate the clinical features of cutaneous adverse reactions to tyrosine kinase inhibitors.Methods Thirty patients with cutaneous adverse reactions to tyrosine kinase inhibitors were enrolled from the First Affiliated Hospital of Guangzhou Medical University between January 2015 and December 2016,and their laboratory test results,histopathological findings and treatment response data were collected and analyzed retrospectively.Results Of the 30 patients,15 presented with acneiform eruptions,10 with eczematoid eruptions,2 with morbilliform rashes,1 with telangiectasia,1 with hand-foot skin reaction,9 with xerosis,7 with nail changes and 4 with hair changes.A patient with grade 4 acneiform eruptions showed a markedly elevated alanine transaminase (ALT) level (315 U/L).Mild ALT abnormalities (48.5-88.1 U/L) were found in 3 patients with grade 3 acneiform eruptions,1 with grade 2 acneiform eruptions,1 with grade 1 acneiform eruptions and 1 with eczematoid eruptions complicated by fever.Two patients with eczematoid eruptions and 1 with morbilliform rashes showed elevated proportions of peripheral blood eosinophils (0.057-0.303).Pathological changes of the acneiform eruptions included hyperkeratosis and dilation of hair follicles and neutrophilic infiltration.Pathological manifestations of eczematoid eruptions included different degrees of spongiosis,thickened spinous layer,irregular elongation of rete ridges and liquefaction degeneration of basal cells in the epidermis,and perivascular infiltration of lymphocytes and eosinophils in the superficial dermis.Patients with grade 1-3 acneiform eruptions received oral minocycline for 6 weeks,skin lesions gradually regressed,but relapse occurred after the withdrawal.After withdrawal of targeted antineoplastic agents and 2-week treatment with systemic glucocorticoids,skin lesions gradually regressed in patients with grade 4 acneiform eruptions,those with eczematoid eruptions complicated by fever,and those with morbilliform rashes.Skin rashes also resolved in patients with mild morbilliform rashes and those with mild eczematoid eruptions after 2 weeks of treatment with antianaphylactic agents and topical glucocorticoids.Oral antibiotics were effective for the treatment of periungual erythematous swelling or granulomas.Conclusion Tyrosine kinase inhibitor-related cutaneous adverse reactions include a constellation of disorders,and hepatic function can be impaired.

ObjectiveTo investigate the relationship between complement-3(C3) and progression of early cerebral infarction.Methods168 consecutive patients with acute cerebral infarction within the first 24 hours from onset were recruited.Fasting venous blood sample was drawn on the morning of the second or the third day after admission.C3 and other clinical chemistry variables were measured.The relationship of C3 and progressing stroke(PS) was analyzed by Logistic regression.Results68 cases(40.48%) were considered as PS.Level of serum C3 in PS patients was 1.28±0.20 g/L higher than in those with non-PS(1.16±0.25 g/L,P=(0.000)).A higher C3 accompanied a higher tendency of prevalence of PS(P=0.001).Logistic regression analysis showed that C3 was significantly correlated with PS(OR for each 1.0 g/L=7.27;95% CI=1.52～36.39; P=0.013).ConclusionElevated serum C3 may play an important role in the prevalence of PS.