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 estimate the prevalence of calcified nodule(CN)among patients with coronary artery disease(CAD)and identify the possible risk factors associated with an increased CN risk.Methods Databases include PubMed,Web of Science and Embase was conducted to identify studies reporting the prevalence and/or risk factors of CN.For this databases,the search was from inception to January 1,2024.Data analyses was performed using R statistical Software 4.2.2.Results A total of 46 studies involving 17 926 patients were included.Among them,13 studies with 4 187 patients reported both the prevalence and associated risk factors.The overall prevalence of CN was found to be 5.72％(95％CI 4.47％-7.31％),while in studies reporting both the prevalence and risk factors,the CN prevalence was slightly higher at 8.72％(95％CI 6.43％-11.71％).Hypertension(OR 1.75,95％CI 1.29-2.37),diabetes(OR 1.84,95％CI 1.46-2.33),chronic kidney disease(OR 2.50,95％CI 1.67-3.74),and hemodialysis(OR 7.77,95％CI 4.77-12.67)were associated with an elevated CN risk(all P＜0.001).Conversely,obesity(OR 0.39,95％CI 0.18-0.83)and history of smoking(OR 0.61,95％CI 0.47-0.80)were linked to a decreased CN risk(both P＜0.05).Conclusions The overall prevalence of CN is relatively low among patients with CAD.However,the prevalence of CN is influenced by a variety of clinical factors.Further research is warranted to elucidate the underlying mechanisms.

As a critical component of global agriculture,the dairy industry is essential for the food security and economic development.In China,the dairy sector in plateau regions plays an important role in addressing the nutritional needs of residents,boosting farmers' incomes,and fostering re-gional economic growth.However,the harsh high-altitude conditions,such as low oxygen,low at-mospheric pressure,and severe climate,pose significant challenges to the health and survival of dairy cows.This article summarizes the changes in physiological characteristics,metabolic perform-ance,production performance,and health status of dairy under high altitude areas,providing in-sights for the identification of adaptive traits in dairy to plateau.Also,the genetic and epigenetic mechanisms behind these phenotypic adaptations are discussed,and future directions and strategies for enhancing adaptability of dairy of dairy n plateau regions are outlined,thereby guiding re-searchers in adaptation evolution and breeding of dairy cattle.

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 establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.

Aim To infer novel therapeutic and phar-macological targets related to lung cancer treatment through multiomics approaches,so as to provide new directions for developing more personalized and effec-tive treatment strategies.Methods Genome-wide as-sociation study(GWAS)data analysis,pan-cancer,single-cell,transcriptomics,and protein-protein interac-tion analysis were employed in this study.Results We analyzed biomarkers and therapeutic targets associ-ated with lung cancer.The study identified key bio-markers closely related to lung cancer progression and explored the interrelationships between these biomark-ers and viral infections.According to KEGG pathway annotation,the number of genes related to metabolic processes increased significantly.In particular,metab-olites such as alanine and isoleucine emerged as pivotal factors in therapeutic interventions.The IgD+CD24+and IgD+CD24-B cell subsets were identified as cen-tral elements in immune evasion and treatment re-sponse.Concurrently,the Lachnospiraceae and Prevo-tella were shown to modulate host immune responses and the tumor microenvironment by regulating short-chain fatty acid levels,thereby opening novel avenues for cancer research.Conclusions Through mul-tiomics analysis combined with transcriptomics and pro-teomics analysis,we identify several potential therapeu-tic targets for lung cancer,providing key insights for developing novel treatment strategies.

Objective:To investigate the expression and clinical value of integrin-associated protein 47 (CD47) and soluble programmed death receptor-ligand 1 (sPD-L1) in patients with primary immune thrombocytopenia (ITP).Methods:The method of retrospective study was adopted, 76 patients with ITP admitted to the Affiliated Hospital of Jining Medical University from July 2016 to July 2022 were regarded as the study group, and another 76 cases of physical examination were regarded as the control group. The levels of serum CD47, sPD-L1, interleukin-33(IL-33) and transforming growth factor beta (TGF-β) were determined by the enzyme-linked immunosorbent assay, the diagnostic value of CD47 and sPD-L1 for ITP was analyzed by the receiver operating characteristic (ROC) curve, Pearson test was applied to analyze the correlation between serum CD47 and sPD-L1 in ITP patients, multivariate Logistic regression analysis was applied to analyze the risk factors affecting ITP.Results:The levels of serum CD47, sPD-L1 and IL-33 in the study group were higher than those in the control group: (40.31 ± 6.59) μg/L vs. (32.16 ± 6.33) μg/L, (78.42 ± 10.22) ng/L vs. (64.49 ± 10.36) ng/L, (73.29 ± 14.26) ng/L vs. (26.54 ± 5.16) ng/L; the level of serum TGF-β in the study group was lower than that in the control group: (1 752.66 ± 310.73) ng/L vs. (2 625.88 ± 389.58) ng/L, there were statistical differences ( P<0.05). The result of the Pearson test showed that there was a positive correlation between serum CD47 and sPD-L1 in ITP patients ( r = 0.572, P<0.05). The result of the ROC curve showed that the area under the curve predicted by the combination of serum CD47 and sPD-L1 was 0.948 (95% CI 0.916 - 0.979), which was better than that predicted by CD47 and sPD-L1 alone ( P<0.05). The result of multivariate Logistic regression analysis showed that CD47, sPD-L1, and IL-33 were the risk factors affecting ITP ( P<0.05), and TGF-β was the protective factor affecting ITP ( P<0.05). Conclusions:The serum levels of CD47 and sPD-L1 in patients with ITP are elevated, and the combined detection of the two indicators has a good diagnostic value for ITP.

Objective To observe the clinical efficacy of lumbar disc resection under unilateral biportal endoscopy(UBE)for calcified lumbar disc herniation(CLDH).Methods A retrospective analysis was conducted on 25 patients with single-segment CLDH who underwent lumbar disc resection under UBE from January 2020 to January 2022.The operation time,postoperative hospital stay,and postoperative complications were recorded.The visual analogue scale(VAS)score for low back and leg pain,Japanese Orthopaedic Association(JOA)score for the lumbar spine,and Oswestry disability index(ODI)were used to evaluate the efficacy before surgery,3 d after surgery,1 month after surgery,and at the last follow-up.At the last follow-up,the modified Macnab standard was used to assess the excellent and good rate.Results The patients were followed up for 12～24 months,with an average of(15.60±2.60)months.The average operation time was(58.67±10.73)min,and the postoperative hospital stay was(4.65±0.63)d.The VAS score,and ODI were lower,and JOA score was higher at 3 d after surgery,1 month after surgery,and the last follow-up compared with those before surgery,and the differences were statistically significant(P<0.05).At the last follow-up,according to the modified Macnab criteria,15 cases were rated as excellent,9 cases as good,and 1 case as fair.The excellent and good rate was 96.00%(24/25).Postoperative complications included a tear of the ventral dural sac of the nerve root,about 5 mm in length,without dural sac repair.The patient was instructed to stay in bed for 5 d after surgery and was given fluid replacement.The patient did not complain of discomfort such as headache when he got out of bed,and the postoperative MRI showed no massive epidural effusion.One patient had lower limb sensory disturbance and was treated with neurotrophic drugs,and recovered at the 1-month follow-up after surgery.Postoperative imaging examinations showed that the free calcified tissues were basically completely resected and the nerve roots were adequately decompressed.At the last follow-up,no recurrent cases were found.Conclusion Lumbar disc resection under UBE for CLDH is an effective and safe minimally invasive technique.

Objective:To explore the protocol for handgrip exercise stress echocardiography by comparing different maximal voluntary contraction（MVC）handgrip groups with bicycle exercise stress.Methods:Forty-one healthy volunteers were enrolled prospectively from June to October 2024 in Tangdu Hospital and utilized a color Doppler echocardiography system，supine cycle ergometer，and handgrip dynamometer to collect echocardiographic data at baseline，during handgrip exercises at 20%（3 min），30%（3 min），and 40%（2 min）of MVC，and spine bicycle exercise stress at peak. Parameters measured included left ventricular ejection fraction（EF），stroke volume（SV），cardiac output（CO），mitral inflow E-wave and A-wave velocities，lateral and septal mitral annular e' velocities，E/A and E/e' ratios，global longitudinal strain（GLS），left atrial reservoir strain（LAS R），conduit strain（LAS CD），and contractile strain（LAS CT）. The non-invasive myocardial work indices were also assessed，including global work index（GWI），global constructive work（GCW），global wasted work（GWW），and global work efficiency（GWE）. Statistical analyses were performed using repeated measures analysis of variance，with corrected paired t-test for comparisons between two exercise stress states. Results:Compared with the baseline state，heart rate，blood pressure，CO、GWI、GCW、GWW and LAS CT gradually increased，while EF、E/A、GLS、GWE、LAS R and LAS CD gradually decreased under 20%，30% and 40% of MVC states. The changes were most obvious at 40% of MVC state，which was selected for the handgrip exercise stress echocardiography protocol.Compared with the peak of bicycle exercise，at 40% of MVC，heart rate was significantly lower［（81.2 ± 9.7）bpm vs.（164.6 ± 11.3）bpm， P<0.05）］，systolic blood pressure was slightly lower［（152.9 ± 13.2）mmHg vs.（165.1 ± 20.4）mmHg， P<0.05］，diastolic blood pressure was higher［（96.0 ± 9.5）mmHg vs.（89.5 ± 10.9）mmHg， P<0.05］，GLS was lower［（19.1 ± 1.5）% vs.（23.5 ± 1.7）%， P<0.05］，GWI was similar［（2 254.2 ± 417.3）mmHg% vs.（2 227.5 ± 389.0）mmHg%， P>0.05］，but GWE was higher［（95.3 ± 2.0）% vs.（93.7 ± 2.0）%， P<0.05］，and LAS R was lower［（39.4 ± 4.2）% vs.（43.9 ± 4.1）%， P<0.05］. Conclusions:The 40% of MVC lasting 2 min can cause the most significant handgrip-related changes in cardiac function and can be used as the standard protocol for handgrip exercise stress echocardiography. Handgrip stress exercise can cause significant changes in cardiac systole，diastole，and work performance，showing different characteristics compared with bicycle exercise stress.

Objective:To evaluate the effects of two dressing methods on wound healing and patient satisfaction after cosmetic suturing for pediatric facial trauma.Methods:A prospective randomized controlled trial was conducted at Dongying People′s Hospital from October 2022 to October 2023. A total of 180 pediatric patients [105 males, 75 females, aged 3-7 (3.9±1.4) years] with facial trauma requiring cosmetic suturing were enrolled in this study. Participants were randomly divided into the study group ( n=91) and control group ( n=89) using a random number table. During the first postoperative dressing change at 24 hours, the study group received saline cleaning followed by erythromycin ointment coverage, while the control group underwent iodine disinfection with gauze coverage. Pain intensity during the second dressing change was assessed using the Chinese version of the Children′s Hospital of Eastern Ontario pain scale (CHEOPS). Wound healing at 6-7 days post-suturing was evaluated using the Chinese version of the redness, edema, ecchymosis, discharge, and approximation (REEDA) scale. Scar appearance at 14 days was measured via the Stony Brook scar evaluation scale (SBSES). Complication rates (infection, dehiscence) and satisfaction rates were statistically analyzed. Results:During the second dressing change, the CHEOPS score was significantly lower in the study group (6.27±1.32) than that in the control group (6.89±1.21) ( P=0.001). At 6-7 days, the REEDA score in the study group (2.26±1.91) was significantly lower than that in the control group (3.07±2.13) ( P=0.008). At 14 days, the SBSES score was significantly lower in the study group [2.60±1.42) vs (3.89±1.50), P<0.001]. The infection rate was 1.09% (1/91) in the study group and 1.12% (1/89) in the control group, with two cases of epidermal dehiscence observed in the control group. The satisfaction rate in the study group was 93.41% (85/91), which was higher than that in the control group [85.49% (76/89), P=0.020]. Conclusion:Saline cleaning combined with erythromycin ointment coverage reduces pain during wound dressing change, facilitates early wound healing, and improves patient′s satisfaction.