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 therapeutic effect of Degludec insulin Liraglutide on obese type 2 diabetes mellitus(T2DM)with poor treatment effect of Metformin.Methods A total of 95 obese T2DM patients with inadequate glycemic control after Metformin therapy admitted to the Second Affiliated Hospital of Guilin Medical University from July 2022 to February 2024 were enrolled.Using a randomized digital table method,patients were divided into observation group(n=47)and control group(n=48).The patients of observation group received Degludec insulin Liraglutide,while the patients of control group was treated with Glargine insulin.Body mass index(BMI),serum C-peptide levels,blood glucose parameters,pancreatic function,lipid profiles,and adverse reaction incidence were compared between two groups.Results After treatment,BMI,postprandial 2-hour blood glucose,fasting blood glucose,glycated hemoglobin,total cholesterol,and low-density lipoprotein cholesterol were significantly lower in observation group than those in control group(P＜0.05).Pancreatic β-cell function index,insulin resistance index,postprandial 2-hour C-peptide,fasting C-peptide,and high-density lipoprotein cholesterol were significantly higher in observation group than those in control group(P＜0.05).There were fewer adverse reactions in observation group than those in control group(P＜0.05).Conclusion The use of Degludec insulin Liraglutide in the treatment of obese T2DM patients with poor effect of Metformin can achieve satisfactory results during the treatment,and pancreatic function,blood glucose,blood lipid and BMI have been significantly improved.The clinical application has a high safety.

Objective To explore the therapeutic effect of Degludec insulin Liraglutide on obese type 2 diabetes mellitus(T2DM)with poor treatment effect of Metformin.Methods A total of 95 obese T2DM patients with inadequate glycemic control after Metformin therapy admitted to the Second Affiliated Hospital of Guilin Medical University from July 2022 to February 2024 were enrolled.Using a randomized digital table method,patients were divided into observation group(n=47)and control group(n=48).The patients of observation group received Degludec insulin Liraglutide,while the patients of control group was treated with Glargine insulin.Body mass index(BMI),serum C-peptide levels,blood glucose parameters,pancreatic function,lipid profiles,and adverse reaction incidence were compared between two groups.Results After treatment,BMI,postprandial 2-hour blood glucose,fasting blood glucose,glycated hemoglobin,total cholesterol,and low-density lipoprotein cholesterol were significantly lower in observation group than those in control group(P＜0.05).Pancreatic β-cell function index,insulin resistance index,postprandial 2-hour C-peptide,fasting C-peptide,and high-density lipoprotein cholesterol were significantly higher in observation group than those in control group(P＜0.05).There were fewer adverse reactions in observation group than those in control group(P＜0.05).Conclusion The use of Degludec insulin Liraglutide in the treatment of obese T2DM patients with poor effect of Metformin can achieve satisfactory results during the treatment,and pancreatic function,blood glucose,blood lipid and BMI have been significantly improved.The clinical application has a high safety.

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.

AIM: To investigate the clinical value of serum vitamin A(Vit A)and basic fibroblast growth factor(bFGF)levels predicting retinopathy of prematurity(ROP).METHODS: Prospective cohort studies. A total of 411 premature or low birth weight infants with gestational age less than 37 wk or birth weight less than 2 500 g who were delivered in Hainan Branch, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were selected as subjects. The Vit A and bFGF levels in peripheral blood were detected at 7 d and 35 d after birth, respectively.RESULTS: A total of 392 premature infants or low birth weight infants completed clinical study, including 51 cases in stage 1-2 ROP group, 23 cases in stage 3-5 ROP group and 318 cases in the group without ROP. At 7 d postnatal, the serum Vit A(0.44±0.17 μmol/L)and bFGF(0.53±0.16 ng/L)levels in stage 1-2 ROP group were lower than those in the group without ROP(0.50±0.12 μmol/L and 0.63±0.15 ng/L; all P<0.05). The serum Vit A(0.34±0.18 μmol/L)and bFGF(0.44±0.18 ng/L)levels in stage 3-5 ROP group were lower than those in the group without ROP(P<0.05). The serum Vit A and bFGF levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(P<0.05). At 35d postnatal, the serum Vit A(0.33±0.19 μmol/L)and bFGF(0.39±0.19 ng/L)levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(0.43±0.16 μmol/L and 0.48±0.17 ng/L; all P<0.05). According to the ROC curve drawn by serum Vit A, the AUC value was 0.853, the maximum Youden index was 0.68, the best sensitivity was 73%, and the best specificity was 95%. According to the ROC curve drawn by serum bFGF, the AUC value was 0.828, the maximum Youden index was 0.58, the best sensitivity was 90%, and the best specificity was 68%. According to the ROC curve drawn by serum Vit A combined with bFGF, the AUC value was 0.917, the maximum Youden index was 0.70, the best sensitivity was 70%, and the best specificity was 100%.CONCLUSION: Serum Vit A and bFGF levels are sensitive and effective indicators for predicting ROP. If the serum Vit A or bFGF levels are lower in premature infants or low birth weight infants, it may indicate the higher probability of ROP and its pathological stages. In addition, the clinica value of serum Vit A combined with bFGF in the diagnosis of ROP is higher than that of Vit A or bFGF alone, and the misdiagnosis rate is reduced.

ObjectiveTo compare the brain imaging characteristics in patients with knee osteoarthritis (KOA) and low back pain (LBP) based on amplitude of low frequency fluctuation (ALFF) of functional magnetic resonance imaging. MethodsFrom August, 2015 to September, 2021, 16 KOA patients and 16 healthy subjects (controls 1) with similar age and gender were recruited from the communities of Fuzhou, Fujian. Other 27 patients with LBP and 32 healthy subjects (controls 2) with similar age and gender were obtained from the Openpain database. The ALFF were analyzed. KOA patients were assessed the pain with Brief Pain Inventory (BPI), and LBP patients were assessed with Visual Analogue Scale (VAS). The correlation between ALFF and pain scores was analyzed. ResultsCompared with their own controls, the ALFF decreased in the left anterior insula for both KOA and LBP patients. The ALFF decreased in the hippocampus and posterior cingulate cortex in KOA patients, while increased in LBP patients. ALFF in the left precuneus, left middle cingulate cortex and right periaqueductal gray matter decreased in KOA patients, and ALFF increased in the right precentral/postcentral gyrus. ALFF of bilateral anterior cingulate cortex, bilateral orbital anterior frontal cortex, left dorsolateral prefrontal cortex and right medial prefrontal cortex decreased in LBP patients, and ALFF increased in the right parahippocampal gyrus and right amygdala. ALFF of the left middle cingulate cortex negatively correlated with BPI score in KOA patients (r = -0.73, P = 0.003), and ALFF of the right hippocampus/amygdala positively correlated with VAS score in LBP patients (r = 0.73, P = 0.003). ConclusionThere are common and specific brain imaging features in different types of chronic pain. The alteration in the left anterior insula, hippocampus and posterior cingulate gyrus may be the common mechanism for KOA and LBP.

OBJECTIVE: To observe the effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the 2nd stage of labor in the primiparas so as to improve the clinical delivery quality. METHODS: A total of 146 primiparas who accepted the natural delivery willingly were collected. According to the visit sequence, they were divided into an observation group (72 cases) and a control group (74 cases). The free position and the unprotected perineal delivery were adopted in combination during the labor in both of the two groups. Additionally, in the observation group, the auricular-point pressure with semen vaccariae was intervened when entering the active phase. The points were pengqiang (TF), zigong (uterus), neishengzhiqi (TF), pizhixia (AT), shenmen (TF), jiaogan (AH), pi (CO) and wei (CO). Each point was pressed for 1 to 2 min each time, repeated once every 10 to 20 min until the end of the 2nd stage of labor. The episiotomy rate, perineal laceration degree, perineal pain degree, the duration of the 2nd labor stage, postpartum hemorrhage, postpartum urine retention and neonatal asphyxia rate were recorded and compared in the primiparas between the two groups. RESULTS: The perineal laceration of the degree Ⅲ and Ⅳ did not occur in the two groups. Compared with the control group, the effect on the perineal laceration was better in the observation group (<0.05). The episiotomy rate was 5.6% (4/72) in the observation group, lower than that in the control group (<0.05). The total perineal laceration rate was 68.1% (48/72) in the observation group, similar to the control group (>0.05). In the observation group, the neonatal asphyxia rate was 1.4% (1/72), the postpartum hemorrhage 6.9% (5/72) and the incidence of urine retention 5.6% (4/72), all lower than 10.8% (8/74), 18.9% (14/74) and 17.6% (13/74) in the control group respectively (all <0.05). In the observation group, on the 1st, 2nd and 3rd days after labor, the perineal pain degree and the duration of the 2nd stage of labor were superior to the control group (all <0.001). CONCLUSION The combined therapy of the auricular-point pressure intervention at the free position and the unprotected perineal delivery technique effectively reduces the episiotomy rate and perineal laceration degree, relieves the perineal pain, reduces the neonatal asphyxia rate and improves the delivery quality during the 2nd stage of labor in the primiparas.
Female ; Humans ; Labor, Obstetric ; Parity ; Perineum ; Pregnancy ; Pressure

OBJECTIVETo investigate the relationship between homocysteine (Hcy), von willebrand factor (vWF), soluble intercellular adhesion molecule-1 (sICAM-1) and the risk of cardio-cerebrovascular events among Inner Mongolians.

METHODSA survey was conducted among 2 589 Inner Mongolians from May 2002 to June 2003, and they were followed up for about ten years. The 182 individuals who developed cardio-cerebrovascular events in the cohort were defined as cases and those whose age, gender and residence 1:1 matched to cases were selected from the individuals who did not developed cardio-cerebrovascular events as controls. Then, a nested case-control study was used to analyze the relationship between Hcy, vWF and sICAM-1 and risk of cardio-cerebrovascular events. Conditonallogistic regression analysis was used to calculate OR values and 95% CI.

RESULTSThe cases had a higher baseline blood pressure, higher prevalence of hypertension and family history of hypertension compared to controls (all P values < 0.05), however, there were no significantly different between TC, TG, LDL-C, HDL-C, FBG, smoking and drinking rates (all P values > 0.05). The M (P(25)-P(75)) of Hcy were 10.68 (7.84-14.98) and 10.02 (6.64-13.94) µmol/L, vWFs were 10.88 (8.14-14.58) and 10.42 (7.97-13.50) mg/L, sICAM-1 were 336.48 (260.68-409.87) and 335.12 (269.87-409.87) ng/ml. They were not significantly different between the two groups (Z values were 0.89, 0.94 and 0.29, respectively, all P values >0.05). After adjustment for the family history of hypertension, hypertension, TC, FPG, BMI, smoking and drinking rate, the conditional logistic regression showed that OR (95% CI) of risk of cardio-cerebrovascular events were 1.00 (0.52-1.93), 2.37 (1.25-4.49), and 0.81 (0.45-1.47) for the participants with increased Hcy, vWF, and sICAM-1, compared with those with normal Hcy, vWF, and sICAM-1, respectively.

CONCLUSIONIn the Inner Mongolians, increased vWF at baseline may increase the risk of cardio-cerebrovascular events, and increased Hcy and sICAM-1 were not significantly associated with the risk of cardio-cerebrovascular events.

Cardiovascular Diseases ; Case-Control Studies ; Cytokines ; Homocysteine ; Humans ; Hypertension ; Intercellular Adhesion Molecule-1 ; Logistic Models ; Prevalence ; Risk ; Risk Factors ; Stroke ; von Willebrand Factor

OBJECTIVETo investigate the relationship between interleukin-6 (IL-6), endothelin-1 (ET-1), E-selectin and the risk of cardio-cerebrovascular events.

METHODSBased on a cohort study in which 2 589 Mongolians had been followed up for 10 years, a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence intervals (95%CI).

RESULTSThe average level of IL-6 (7.66 vs. 8.77 pg/ml), ET-1 (0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml)were not significantly different between the case and the control groups (P > 0.05). Data from the logistic regression analysis showed that IL-6, ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs (95%CI) on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16), 1.10 (0.66-1.85) and 1.19 (0.71-2.00) for the participants with IL-6>23.91 pg/ml, ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml, respectively, compared with those having IL-6≤23.91 pg/ml, ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml.

CONCLUSIONData from our study indicated that the levels of IL-6, ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

Cardiovascular Diseases ; epidemiology ; Case-Control Studies ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Cohort Studies ; E-Selectin ; blood ; Endothelin-1 ; blood ; Humans ; Interleukin-6 ; blood ; Odds Ratio ; Risk

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.