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 prognostic value of artificial intelligence-based P53 and Ki67 detection in stage I non-mucinous adenocarcinoma(INMA)of lung.Methods:A retrospective analysis was made of patients treated by radical surgical resection for INMA of lung in the Department of Thoracic Surgery of Peking University First Hospital from Jan.2015 to Dec.2016,with complete clinicopathological and 5-year follow-up data.Immunohistochemical staining for P53 and Ki67 was performed on all cases and the index of P53 and Ki67 was calculated with the assistance of artificial intelligence(AI).The optimal cut-off values for P53 and Ki67 were determined using X-Tile software,and based on these values,the patients were divided into low-expression and high-expression groups.Pearson chi-square test and Fisher's exact test were used to compare the differences in clinicopathological characteristics between the different groups.Univariate and multivariate Cox regression analyses were performed to assess the impact of various indicators on 5-year overall survival(OS)and disease-free survival (DFS)for stage I INMA.The time-dependent receiver operating characteristic(ROC) curves and the area under the curve(AUC)was used to analyze the predictive performance of P53 and Ki67 for the prognosis of stage I INMA.Results:Among the 191 patients, the median follow-up time was 60(54, 60) months. The index of P53 and Ki67 were 0%-100% and 1.0%-78.0%,respectively. The X-Tile software revealed optimal cut-off values of 62% for P53 and 20% for Ki67.Then the patients were divided into P53 low-expression group (<62%), P53 high-expression (≥62%) group and Ki67 low-expression (<20%)group,Ki67 high-expression group (≥20%). High expression of P53 was associated with male ( χ2=12.45, P<0.001), smoking ( χ2=12.24, P<0.001), pTNM stage ( χ2=16.28, P<0.001), and histological grade ( P<0.001). High expression of Ki67 was associated with male ( χ2=17.33, P<0.01), smoking ( χ2=21.67, P<0.01), and histological grade ( P<0.001). Male ( HR=2.612, 95% CI: 1.173-5.815, P=0.019), smoking ( HR=2.651, 95% CI: 1.246-5.642, P=0.011), high pTNM stage ( HR=3.815, 95% CI: 1.792-8.122, P<0.001), high histological grade ( HR=5.277, 95% CI: 2.400-11.606, P<0.001), high P53 expression ( HR=5.950, 95% CI: 2.792-12.680, P<0.001), and high Ki67 expression ( HR=3.349, 95% CI: 1.554-7.221, P=0.002) were associated with poorer disease-free survival (DFS). Male ( HR=9.050, 95% CI: 1.113-73.586, P=0.039), smoking ( HR=8.428, 95% CI: 1.701-41.765, P=0.009), high histological grade ( HR=6.865, 95% CI: 1.756-26.834, P=0.006), high P53 expression ( HR=16.699, 95% CI: 3.369-82.761, P<0.001), and high Ki67 expression ( HR=7.558, 95% CI: 1.806-31.632, P=0.006) were associated with poorer overall survival. P53 high-expression was identified as an independent risk factor for both DFS ( HR=2.843, 95% CI: 1.192-6.778, P=0.018) and OS( HR=6.909, 95% CI: 1.202-39.720, P=0.030) in stage I INMA patients. The area under the time-dependent ROC curves for predicting 5-year overall survival after surgery were 0.738 for p53, 0.674 for Ki67, 0.638 for pTNM staging, and 0.587 for histological grade. Among these, p53 demonstrated the highest predictive efficacy. Conclusions:AI-assisted interpretation of P53 and Ki67 indices improves test result repeatability. With critical values of 62% and 20%, high P53 and Ki67 expression indicates poor prognosis, while high P53 expression is an independent risk factor for lower OS and DFS, serving as a reference for postoperative adjuvant therapy screening.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To introduce an innovative technique, the "balance-shaped sternal elevation device" and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for anterior mediastinal masses resection. Methods Patients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from May to June 2024 were included, and their clinical data were analyzed. Results A total of 7 patients were included, with 3 males and 4 females, aged 28-72 years. The diameter of the tumor was 1.9-17.0 cm. The operation time was 62-308 min, intraoperative blood loss was 5-100 mL, postoperative chest drainage tube retention time was 0-9 days, pain score on the 7th day after surgery was 0-2 points, and postoperative hospital stay was 3-12 days. All patients underwent successful and complete resection of the masses and thymus, with favorable postoperative recovery. Conclusion The "balance-shaped sternal elevation device" effectively expands the retrosternal space, providing surgeons with satisfactory surgical views and operating space. This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses, reduces trauma and postoperative pain, and accelerates patient recovery, demonstrating important clinical significance and application value.

Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.

Objective:To observe the efficacy of plasma beam combined with intense pulsed light on facial burn scars and its impact on scar score and pain level.Method:This study was a prospective study,and a random number table method was used to divided 92 patients with facial burn scars who were admitted to Maoming People's Hospital from March 2024 to August 2024 into control group(received intense pulsed light treatment,46 cases)and study group(received plasma beam treatment in addition to the control group,46 cases).The efficacy,related scale scores,scar recovery and incidence of adverse reaction rates between two groups were compaerd.Result:Compared with control group after treatment,the clinical total effective rate and the chinese version of the simplified burn health scale(BSHS-B)score of the study group were higher,while vancouver scar scale(VSS),visual analogue scale(VAS)scores,scar thickness,and scar blood flow perfusion were lower(P＜0.05).There was no significant difference in the incidence of adverse reaction rates between the two groups(P＞0.05).Conclusion:Plasma beam combined with intense pulsed light on facial burn scars,can improve clinical efficacy,improve scar thickness and blood flow perfusion,alleviate scar itching and pain,and has good safety in treating facial burn scar patients.

Objective:To observe the efficacy of plasma beam combined with intense pulsed light on facial burn scars and its impact on scar score and pain level.Method:This study was a prospective study,and a random number table method was used to divided 92 patients with facial burn scars who were admitted to Maoming People's Hospital from March 2024 to August 2024 into control group(received intense pulsed light treatment,46 cases)and study group(received plasma beam treatment in addition to the control group,46 cases).The efficacy,related scale scores,scar recovery and incidence of adverse reaction rates between two groups were compaerd.Result:Compared with control group after treatment,the clinical total effective rate and the chinese version of the simplified burn health scale(BSHS-B)score of the study group were higher,while vancouver scar scale(VSS),visual analogue scale(VAS)scores,scar thickness,and scar blood flow perfusion were lower(P＜0.05).There was no significant difference in the incidence of adverse reaction rates between the two groups(P＞0.05).Conclusion:Plasma beam combined with intense pulsed light on facial burn scars,can improve clinical efficacy,improve scar thickness and blood flow perfusion,alleviate scar itching and pain,and has good safety in treating facial burn scar patients.

Objective:To explore the prognostic value of artificial intelligence-based P53 and Ki67 detection in stage I non-mucinous adenocarcinoma(INMA)of lung.Methods:A retrospective analysis was made of patients treated by radical surgical resection for INMA of lung in the Department of Thoracic Surgery of Peking University First Hospital from Jan.2015 to Dec.2016,with complete clinicopathological and 5-year follow-up data.Immunohistochemical staining for P53 and Ki67 was performed on all cases and the index of P53 and Ki67 was calculated with the assistance of artificial intelligence(AI).The optimal cut-off values for P53 and Ki67 were determined using X-Tile software,and based on these values,the patients were divided into low-expression and high-expression groups.Pearson chi-square test and Fisher's exact test were used to compare the differences in clinicopathological characteristics between the different groups.Univariate and multivariate Cox regression analyses were performed to assess the impact of various indicators on 5-year overall survival(OS)and disease-free survival (DFS)for stage I INMA.The time-dependent receiver operating characteristic(ROC) curves and the area under the curve(AUC)was used to analyze the predictive performance of P53 and Ki67 for the prognosis of stage I INMA.Results:Among the 191 patients, the median follow-up time was 60(54, 60) months. The index of P53 and Ki67 were 0%-100% and 1.0%-78.0%,respectively. The X-Tile software revealed optimal cut-off values of 62% for P53 and 20% for Ki67.Then the patients were divided into P53 low-expression group (<62%), P53 high-expression (≥62%) group and Ki67 low-expression (<20%)group,Ki67 high-expression group (≥20%). High expression of P53 was associated with male ( χ2=12.45, P<0.001), smoking ( χ2=12.24, P<0.001), pTNM stage ( χ2=16.28, P<0.001), and histological grade ( P<0.001). High expression of Ki67 was associated with male ( χ2=17.33, P<0.01), smoking ( χ2=21.67, P<0.01), and histological grade ( P<0.001). Male ( HR=2.612, 95% CI: 1.173-5.815, P=0.019), smoking ( HR=2.651, 95% CI: 1.246-5.642, P=0.011), high pTNM stage ( HR=3.815, 95% CI: 1.792-8.122, P<0.001), high histological grade ( HR=5.277, 95% CI: 2.400-11.606, P<0.001), high P53 expression ( HR=5.950, 95% CI: 2.792-12.680, P<0.001), and high Ki67 expression ( HR=3.349, 95% CI: 1.554-7.221, P=0.002) were associated with poorer disease-free survival (DFS). Male ( HR=9.050, 95% CI: 1.113-73.586, P=0.039), smoking ( HR=8.428, 95% CI: 1.701-41.765, P=0.009), high histological grade ( HR=6.865, 95% CI: 1.756-26.834, P=0.006), high P53 expression ( HR=16.699, 95% CI: 3.369-82.761, P<0.001), and high Ki67 expression ( HR=7.558, 95% CI: 1.806-31.632, P=0.006) were associated with poorer overall survival. P53 high-expression was identified as an independent risk factor for both DFS ( HR=2.843, 95% CI: 1.192-6.778, P=0.018) and OS( HR=6.909, 95% CI: 1.202-39.720, P=0.030) in stage I INMA patients. The area under the time-dependent ROC curves for predicting 5-year overall survival after surgery were 0.738 for p53, 0.674 for Ki67, 0.638 for pTNM staging, and 0.587 for histological grade. Among these, p53 demonstrated the highest predictive efficacy. Conclusions:AI-assisted interpretation of P53 and Ki67 indices improves test result repeatability. With critical values of 62% and 20%, high P53 and Ki67 expression indicates poor prognosis, while high P53 expression is an independent risk factor for lower OS and DFS, serving as a reference for postoperative adjuvant therapy screening.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.