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.

OBJECTIVES: To investigate the structural changes of rat thoracic aorta and changes in expression levels of Bmal1 and cyclins in thoracic aorta endothelial cells following heat stress. METHODS: Twenty male SD rats were randomized equally into control group and heat stress group. After exposure to 32 ℃ for 2 weeks in the latter group, the rats were examined for histopathological changes and Bmal1 expression in the thoracic aorta using HE staining and immunohistochemistry. In the cell experiments, cultured rat thoracic aortic endothelial cells (RTAECs) were incubated at 40 ℃ for 12 h with or without prior transfection with a Bmal1-specific small interfering RNA (si-Bmal1) or a negative sequence. In both rat thoracic aorta and RTAECs, the expressions of Bmal1, the cell cycle proteins CDK1, CDK4, CDK6, and cyclin B1, and apoptosis-related proteins Bax and Bcl-2 were detected using Western blotting. TUNEL staining was used to detect cell apoptosis in rat thoracic aorta, and the changes in cell cycle distribution and apoptosis in RTAECs were analyzed with flow cytometry. RESULTS: Compared with the control rats, the rats exposed to heat stress showed significantly increased blood pressures and lowered heart rate with elastic fiber disruption and increased expressions of Bmal1, cyclin B1 and CDK1 in the thoracic aorta (P<0.05). In cultured RTAECs, heat stress caused significant increase of Bmal1, cyclin B1 and CDK1 protein expression levels, which were obviously lowered in cells with prior si-Bmal1 transfection. Bmal1 knockdown also inhibited heat stress-induced increase of apoptosis in RTAECs as evidenced by decreased expression of Bax and increased expression of Bcl-2. CONCLUSIONS Heat stress upregulates Bmal1 expression and causes alterations in expressions of cyclins to trigger apoptosis of rat thoracic aorta endothelial cells, which can be partly alleviated by suppressing Bmal1 expression.
Animals ; ARNTL Transcription Factors/genetics* ; Male ; Aorta, Thoracic/metabolism* ; Rats ; Rats, Sprague-Dawley ; Endothelial Cells/metabolism* ; Apoptosis ; Cells, Cultured ; Heat-Shock Response ; Cyclin B1/metabolism* ; CDC2 Protein Kinase/metabolism* ; Cyclins/metabolism* ; RNA, Small Interfering ; bcl-2-Associated X Protein/metabolism*

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 research hotspots and trends in forensic mental health nursing internationally.Methods:The Web of Science Core Collection Database was searched for research on forensic mental health nursing, with the search period covering the database's inception to December 31, 2023. CiteSpace 6.1.R4 and VOSviewer 1.6.19 were used to visually analyze research hotspots and trends in forensic mental health nursing.Results:From 1992 to 2023, the volume of publications on forensic mental health nursing steadily increased, with the highest number of publications in 2022 (155 papers). The United Kingdom had the most publications (455 papers), and King's College London was the leading institution (50 papers). The Journal of Forensic Psychiatry was the most frequently published (120 papers). Research hotspots in forensic mental health nursing included forensic mental health care for trauma victims, forensic mental health rehabilitation and forensic mental health nursing management, risk assessment in forensic mental health care, and forensic mental health nursing for schizophrenia. Trauma care for forensic mental health patients became a new research trend. Conclusions:Interest in forensic mental health nursing research is rising internationally. Domestic research can benefit from these trends to promote the development of forensic mental health.

Objective:To systematically evaluate the risks of gastrointestinal reactions induced by sodium-glucose transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus.Methods:Randomized controlled trials of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus, in which gastrointestinal reactions were evaluated as one of outcome indicators, were collected by searching relevant databases at home and abroad (up to December 30, 2022). Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies. Stata 15.1 software was used to conduct Bayesian network meta-analysis, including drawing the network evidence plot, the league map of pairwise comparison, and the surface under the cumulative ranking curve (SUCRA) for gastrointestinal reaction risks with different interventions of SGLT2 inhibitors, and ranking the risks of gastrointestinal reaction of different interventions of SGLT2 inhibitors. The effect sizes of gastrointestinal reaction were expressed by relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 15 studies were included in the analysis, involving 5 540 patients with 3 949 in the SGLT2 inhibitor treatment group and 1 591 in the control group. Drugs that used in the treatment group included dapagliflozin (in 1 872 patients), canagliflozin (in 1 100 patients), empagliflozin (in 649 patients), ertugliflozin (in 219 patients), ipragliflozin (in 61 patients), and licogliflozin (in 48 patients). All patients in the control group were treated with placebo. The results of the network meta-analysis showed that the risk of gastrointestinal reactions was higher after treatment with 10 mg of ertugliflozin, compared with those with 50 mg and 100 mg of canagliflozin ( RR=1.37, 95% CI: 1.02-3.48; RR=2.98, 95% CI: 1.19-4.09; all P<0.05). There was no statistically significant difference in comparison between other interventions with SGLT2 inhibitors. According to the results of SUCRA on the relative risks for gastrointestinal reactions of different interventions with SGLT2 inhibitors, interventions were ranked as licogliflozin 50 mg, ertugliflozin 25 mg, ertugliflozin 10 mg, empagliflozin 25 mg, ipragliflozin 100 mg, ipragliflozin 300 mg, ipragliflozin 200 mg, ertugliflozin 5 mg, licogliflozin 10 mg, ipragliflozin 50 mg, empagliflozin 10 mg, licogliflozin 2.5 mg, dapagliflozin 20 mg, dapagliflozin 10 mg, empagliflozin 5 mg, ertugliflozin 1 mg, dapagliflozin 5 mg, placebo, canagliflozin 300 mg, canagliflozin 200 mg, dapagliflozin 2.5 mg, dapagliflozin 1 mg, canagliflozin 100 mg, canagliflozin 50 mg. Conclusions:Different SGLT2 inhibitor treatment regimens lead to different risks of gastrointestinal reactions in patients with type 2 diabetes. The risk of gastrointestinal reactions caused by canagliflozin is low, especially under the dose of 50 mg. Licogliflozin and ertugliflozin have greater possibility to cause gastrointestinal reactions, especially when they were used at high doses.

Objective:To systematically evaluate the risks of gastrointestinal reactions induced by sodium-glucose transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus.Methods:Randomized controlled trials of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus, in which gastrointestinal reactions were evaluated as one of outcome indicators, were collected by searching relevant databases at home and abroad (up to December 30, 2022). Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies. Stata 15.1 software was used to conduct Bayesian network meta-analysis, including drawing the network evidence plot, the league map of pairwise comparison, and the surface under the cumulative ranking curve (SUCRA) for gastrointestinal reaction risks with different interventions of SGLT2 inhibitors, and ranking the risks of gastrointestinal reaction of different interventions of SGLT2 inhibitors. The effect sizes of gastrointestinal reaction were expressed by relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 15 studies were included in the analysis, involving 5 540 patients with 3 949 in the SGLT2 inhibitor treatment group and 1 591 in the control group. Drugs that used in the treatment group included dapagliflozin (in 1 872 patients), canagliflozin (in 1 100 patients), empagliflozin (in 649 patients), ertugliflozin (in 219 patients), ipragliflozin (in 61 patients), and licogliflozin (in 48 patients). All patients in the control group were treated with placebo. The results of the network meta-analysis showed that the risk of gastrointestinal reactions was higher after treatment with 10 mg of ertugliflozin, compared with those with 50 mg and 100 mg of canagliflozin ( RR=1.37, 95% CI: 1.02-3.48; RR=2.98, 95% CI: 1.19-4.09; all P<0.05). There was no statistically significant difference in comparison between other interventions with SGLT2 inhibitors. According to the results of SUCRA on the relative risks for gastrointestinal reactions of different interventions with SGLT2 inhibitors, interventions were ranked as licogliflozin 50 mg, ertugliflozin 25 mg, ertugliflozin 10 mg, empagliflozin 25 mg, ipragliflozin 100 mg, ipragliflozin 300 mg, ipragliflozin 200 mg, ertugliflozin 5 mg, licogliflozin 10 mg, ipragliflozin 50 mg, empagliflozin 10 mg, licogliflozin 2.5 mg, dapagliflozin 20 mg, dapagliflozin 10 mg, empagliflozin 5 mg, ertugliflozin 1 mg, dapagliflozin 5 mg, placebo, canagliflozin 300 mg, canagliflozin 200 mg, dapagliflozin 2.5 mg, dapagliflozin 1 mg, canagliflozin 100 mg, canagliflozin 50 mg. Conclusions:Different SGLT2 inhibitor treatment regimens lead to different risks of gastrointestinal reactions in patients with type 2 diabetes. The risk of gastrointestinal reactions caused by canagliflozin is low, especially under the dose of 50 mg. Licogliflozin and ertugliflozin have greater possibility to cause gastrointestinal reactions, especially when they were used at high doses.

Objective:To analyze the risk factors of persistent atelectasis in patients undergoing radical resection of lung cancer and construct a predictive model for persistent atelectasis after lung cancer surgery.Methods:Using the convenient sampling method, a total of 332 patients undergoing video-assisted thoracic surgery (VATS) at Department of Thoracic Surgery in Shanghai Pulmonary Hospital affiliated to Tongji University were selected from July 2019 to June 2020. Patients were divided into non-persistent atelectasis group ( n=104) and persistent atelectasis group ( n=228). Logistic regression analysis was used to investigate the independent predictors of perioperative persistent atelectasis in patients undergoing radical lung cancer surgery, and a predictive model was established. Results:Body mass index, tumor TNM stage, pathological category, history of chronic obstructive pulmonary disease and preoperative neoadjuvant therapy (chemotherapy, immunotherapy, and targeted therapy) were independent predictors of persistent atelectasis after VATS ( P<0.05). Based on the above predictive factors, a predictive model of persistent atelectasis during the perioperative period was established. Logit ( P) = 2.015 + 0.836 × body mass index + 2.515 × history of chronic obstructive pulmonary disease-1.451 × pathological type-1.700 (stage Ⅰ) /1.146 (stage Ⅱ) × tumor TNM stage + 3.312 × neoadjuvant therapy history. Conclusions:The predictive model constructed in this study can provide a theoretical basis for screening high-risk patients with persistent atelectasis and provide a reference for clinical medical staff to take preventive treatment and nursing care for high-risk patients in time.

Objective:To investigate the role of down-regulating serine racemase (SRR) in alleviating the β-amyloid peptide (Aβ) induced neurotoxicity and synaptic damage and possible mechanism in PC12 cells.Methods:(1) PC12 cells cultured in vitro were divided into 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups; they were treated with 0, 20, 40 and 80 μmol/L Aβ 25-35 for 24 h, respectively; cell counting kit (CCK)-8 was used to detect the survival rate of cells in each group, and Western blotting was used to detect the SRR protein expression. PC12 cells were treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h, respectively; cell survival and SRR protein expression were detected by CCK-8 and Western blotting, respectively. (2) PC12 cells were divided into control group, nonsense sequence group, SRR small interfering RNA (siRNA) group 1, SRR siRNA group 2, and SRR siRNA group 3; cells in the later three groups were transfected with SRR nonsense sequence or different SRR siRNA sequences, respectively; 48 h after that, Western blotting was used to detect the SRR protein expression of cells in each group, and SRR siRNA with best effect was selected for subsequent experiments. (3) PC12 cells were divided into control group, AD group, AD+nonsense sequence group, and AD+SRR siRNA group; cells in the latter two groups were transfected with nonsense sequence or SRR siRNA for 48 h, respectively; cells in the latter three groups were added 40 μmol/L Aβ 25-35, and cells in the control group were added same amount of solvent; 24 h after treatment, the SRR protein expression was detected by Western blotting, cell survival was detected by CCK-8, cell apoptosis was detected by Hoechst 33258 fluorescent staining, Caspase 3 activity was detected by enzyme linked immunosorbent assay, and the expressions of activated Caspase 3, N-methyl- D aspartate (NMDA) receptor-associated proteins and postsynaptic dense protein 95 (PSD95) were detected by Western blotting. Results:(1) The survival rate of cells in 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups was successively decreased and the SRR protein expression was successively increased, with significant differences ( P<0.05); PC12 cells treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h had successively decreased survival rate and successively increased SRR protein expression, with significant differences ( P<0.05). (2) The SRR protein expressions in the SRR siRNA group 1, SRR siRNA group 2 and SRR siRNA3 group 3 were significantly decreased as compared with those in the control group and nonsense sequence group ( P<0.05), and the decrease in the SRR siRNA group 2 was the most obvious. (3) As compared with the control group, the cells in the AD group had significantly increased SRR protein expression and apoptosis rate, statistically decreased cell survival rate, significantly increased Caspase 3 activity and activated Caspase 3 protein expression, significantly increased protein expressions of NMDA receptor 2A (NMDAR2A) and NMDA receptor 2B(NMDAR2B), and statistically decreased PSD95 protein expression ( P<0.05); as compared with cells in the AD group, cells in the AD+SRR siRNA group had significantly decreased SRR protein expression and apoptosis rate, statistically increased cell survival rate, significantly decreased Caspase 3 activity and activated Caspase 3 protein expression, significantly decreased NMDAR2A protein expression, and statistically increased PSD95 protein expression ( P<0.05). Conclusion:Down-regulation of SRR expression can reduce the NMDAR2A protein expression, alleviate the over-activation of NMDA receptor, reduce the cell apoptosis, improve cell survival rate, protect nerve cells, increase PSD95 protein expression, and alleviate synaptic damage in PC12 cells.

Objective To construct the standard nursing path index for perioperative enhanced recovery of patients after thoracoscopic lobectomy, and to provide theoretical basis for providing high quality nursing services for patients after thoracoscopic lobectomy. Methods Based on evidence-based medicine, systematic literature review and expert group meetings were organized to form the first draft of standard nursing pathway index for perioperative enhanced recovery of thoracoscopic lobectomy. Through Delphi method, 55 thoracic surgery medical and nursing experts were consulted for two rounds, and the structure and entries of the first draft were revised. Finally, a set of perioperative enhanced recovery standard nursing path index was formed. Results The recovery rate of the two rounds of expert consultation questionnaire were both 100%. The authoritative coefficients of experts in the two rounds were 0.855 and 0.874, and the coordination coefficients Kendall's W were 0.35 and 0.44, respectively. The standard nursing path index of perioperative enhanced recovery after thoracoscopic lobectomy included 4 dimensions (preoperative baseline assessment, preoperative preparation, intraoperative nursing intervention, postoperative nursing intervention), 25 items. Conclusions In this study, experts' enthusiasm and authority are high, opinions are well coordinated, the results are reliable, and the indexes can better meet the actual needs of patients, which can provide a basis for the next step to carry out perioperative enhanced recovery nursing practice for patients undergoing thoracoscopic lobectomy.