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.

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 analyze the preventing effect of pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) on granulocytopenia after chemotherapy for prostate cancer, and to evaluate its safety and effectiveness.Methods:A total of 61 patients aged 53-82 with metastatic hormone-sensitive prostate cancer (mHSPC), who received docetaxel (75 mg/m 2, 21 days constitute one chemotherapy course) alone or docetaxel (75 mg/m 2 on d1) combined with cisplatin (30 mg/m 2, from d1 to d3) and carboplatin (400 mg/m 2, from d1 to d3) during a 21-day chemotherapy course from February 2019 to December 2019, were included. These patients also received endocrine therapy over the same period, including surgical and medical castration, and castration combined with antiandrogen medications, lasting 6 cycles in total. Patients were divided into two groups, the control group (30 cases) and the observation group (31 cases). The control group received no leukogenic drugs, and was given human granulocyte stimulating factor (rhG-CSF) treatment only after the occurrence of granulocytopenia until the WBC count in peripheral blood was above 10×10 9/L. The observation group was given PEG-rhG-CSF within 48 hours after chemotherapy. Results:Among the 61 patients, one patient died, two stopped receiving chemotherapy due to liver dysfunction, one was lost to follow-up. A total of 57 valid cases were included in per protocol set (PPS) in the end, of which 30 cases were from the observation group and 27 cases from the control group. The incidence of neutropenia in the observation group was 33.3%, of which the incidence of grade 3 neutropenia was 10.0%, the incidence of agranulocytosis was 0, and the drug doses reduction of chemotherapy was 0, which were lower than the 77.8%, 33.3%, 18.5%, and 18.5%, respectively, in the control group, with statistically significant differences ( P<0.05). The differences in adverse reactions in both groups, included aching bones, muscle pain, lack of strength, and soreness at the injection sites, were of no statistical significance ( P>0.05). Conclusion:The curative effect of PEG-rhG-CSF is definite on the patients with mHSPC who received chemotherapy either with docetaxel alone or docetaxel combined with cisplatin and carboplatin. It can reduce the incidence of granulocytopenia, agranulocytosis, and chemotherapy drug dose reduction caused by myelosuppression. It, therefore, can ensure the patients receive chemotherapy with standard dosage, and thus improve the cure rate.

Objective:To analyze the preventing effect of pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) on granulocytopenia after chemotherapy for prostate cancer, and to evaluate its safety and effectiveness.Methods:A total of 61 patients aged 53-82 with metastatic hormone-sensitive prostate cancer (mHSPC), who received docetaxel (75 mg/m 2, 21 days constitute one chemotherapy course) alone or docetaxel (75 mg/m 2 on d1) combined with cisplatin (30 mg/m 2, from d1 to d3) and carboplatin (400 mg/m 2, from d1 to d3) during a 21-day chemotherapy course from February 2019 to December 2019, were included. These patients also received endocrine therapy over the same period, including surgical and medical castration, and castration combined with antiandrogen medications, lasting 6 cycles in total. Patients were divided into two groups, the control group (30 cases) and the observation group (31 cases). The control group received no leukogenic drugs, and was given human granulocyte stimulating factor (rhG-CSF) treatment only after the occurrence of granulocytopenia until the WBC count in peripheral blood was above 10×10 9/L. The observation group was given PEG-rhG-CSF within 48 hours after chemotherapy. Results:Among the 61 patients, one patient died, two stopped receiving chemotherapy due to liver dysfunction, one was lost to follow-up. A total of 57 valid cases were included in per protocol set (PPS) in the end, of which 30 cases were from the observation group and 27 cases from the control group. The incidence of neutropenia in the observation group was 33.3%, of which the incidence of grade 3 neutropenia was 10.0%, the incidence of agranulocytosis was 0, and the drug doses reduction of chemotherapy was 0, which were lower than the 77.8%, 33.3%, 18.5%, and 18.5%, respectively, in the control group, with statistically significant differences ( P<0.05). The differences in adverse reactions in both groups, included aching bones, muscle pain, lack of strength, and soreness at the injection sites, were of no statistical significance ( P>0.05). Conclusion:The curative effect of PEG-rhG-CSF is definite on the patients with mHSPC who received chemotherapy either with docetaxel alone or docetaxel combined with cisplatin and carboplatin. It can reduce the incidence of granulocytopenia, agranulocytosis, and chemotherapy drug dose reduction caused by myelosuppression. It, therefore, can ensure the patients receive chemotherapy with standard dosage, and thus improve the cure rate.

Discordance, such as overlap, repetition and inconsistent, of standards is one of the major problems in current standardization affair in China. Therefore, improving the unity and authority of standards through reduction of overlap, repetition and inconsistency has become the main goal of deepening standardization reform in China. This paper summarizes the discordance in public health standards in China, analyzes the major reasons and provides specific strategic suggestions through case analysis of public health standards in the ways of comparisons of same kind standards of other deparments and standards in administration documents and guidelines or technical specifications of academic associations or societies.

Objective:To investigate the effects of Purendan Superfine Powder (PRD) on the retinal hemodynamics and the expressions of cytokines in the diabetic rats, and to elucidate its protective effect on diabetic retinopathy (DR) .Methods:Thirty-six male SD rats were randomly divided into control group, diabetes group, and PRD group (n=12) .The diabetes rat models were established by intraperitoneal injecting streptozotocin (STZ) in diabetes group and PRD group.After successful modeling, the diabetic rats in PRD group were given PRD (1.8g·kg-1) by gavage for 3months.The hemodynamics parameters of central retinal artery (CRA) of the rats were measured with color Doppler ultrasound.The expression levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) mRNA in retina tissue were detected by reverse transcription polymerase chain reaction (RT-PCR) .Immunohistochemical staining and Western blotting methods were used to detect the expression levels of VEGF and bFGF proteins in retina tissue of the rats.Results:Compared with control group, the blood glucose, urine volume, liver index and kidney index of the rats in diabetes group were significantly increased (P＜0.05) , the peak systolic velocity (PSV) , end diastolic velocity (EDV) and mean velocity (MV) of CRA were significantly decreased (P＜0.05) , the resistant index (RI) and pulsatility index (PI) of CRA were significantly increased (P＜0.05) , and the expression levels of VEGF and bFGF mRNA and protein in retina tissue were significantly increased (P＜0.05) .Compared with diabetes group, the blood glucose, urine volume, liver index and kidney index of the rats in PRD group were significantly decreased (P＜0.05) , the PSV, EDV and MV of CRA were increased (P＜0.05) , the RI and PI of CRA were decreased (P＜0.05) , the expression levels of VEGF and bFGF mRNA and protein in retina tissue were significantly reduced (P＜0.05) .Conclusion:PRD can protect the diabetic retinal microvascular injury by reducing the blood glucose level, increasing the blood supply of retinal tissue, increasing the amount of microcirculation blood perfusion, reducing the vascular bed perfusion resistance, and reducing the expression of VEGF and bFGF.

BACKGROUND:With the development of surgical techniques and reconstruction material technology, joint replacement has also been widely used in the dislocation of the shoulder;especial y al kinds of custom-made or assembled prosthesis make replacement indications improved evidently. OBJECTIVE:To investigate the long-term effects of arthroscopy or arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects. METHODS:144 patients with recurrent anterior dislocation of the shoulder joint with severe bone defects were enrol ed in this study. They were divided into treatment group and control group based on a random drawing (n=72). The control group was given arthroscopic surgery, and the treatment group was subjected to arthroplasty. The 3 years of fol owed-up were done by telephone investigation and further consultation. Neer shoulder score, shoulder activity and complications were recorded.
RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

BACKGROUND:Traditionaly, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible.
OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation.
METHODS:A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equaly and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. Al patients were folowed up for 6 months after treatment to investigate the occurrence of complications.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. At 7 days after treatment, the excelent and good rate was 94% in the treatment group and 75% in the control group. The excelent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month folow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of postoperative complications.

BACKGROUND:Arthroscopy can observe the involutive relation of patelofemoral joint directly and dynamicaly, which can be used to judge whether the patelofemoral joint abnormalities can be completely corrected. OBJECTIVE:To analyze the clinical effect of lateral retinacular release and ligament reconstruction under arthroscope for patela recurrent dislocation. METHODS: A total of 58 patients diagnosed as having recurrent patelar dislocations were divided randomly into control and experimental groups, with 29 cases in each group. Patients in the control group received lateral retinacular release and ligament reconstruction under common operation and those in the experimental group received lateral retinacular release and ligament reconstruction under arthroscopy. RESULTS AND CONCLUSION:There was no significant difference in the Lysholm and Kujala scores before treatment in the two groups (P > 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P < 0.05). No difference was found in the congruence angle and lateral patelofemoral angle with CT value at 30° of knee flexion (P > 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.

Objective To study the short-term(≤1 year) effect of video-thoracoscope in the treatment of chronic obstructive pulmonary diseases (COPD) accompanied with pneumothorax.Methods 52 COPD cases with pneumothorax from June 2005 to June 2007 were divided into thoracoscope group(n=28) and open heart group(n=24).The patients were followed up at 1,6 and 12 month after surgery,for determination of BODE index,including body mass index,air block,difficulty in respiratory and motor ability.Results No operative death and servere complicatins occurred.Pneumothorax did not relapse.One month after surgery,air block was[(58.62±15.73)% vs (50.12±11.38)%],difficulty in respiratory was[(1.04±0.37)s vs( 1.72±0.45)s] and motor ability was [(387.32±52.07)m vs (318.35±61.52)m] in thoracoscope group and open heart group (P<0.05).At the six month after surgery,body mass index was[(27.19±2.18)kg/m2 vs (20.90±2.35)kg/m2] in thoracoscope group and open heart group(P<0.05);At the 12 month after operation,there was no significant difierence in BODE index between the two groups(P>0.05).Conclusions Video-thoracoscope in treating COPD with pneumothorax can remarkably improve the quality of life early after surgery.