BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects. OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment. METHODS:The English search terms were"efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,"which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was"efferocytosis,"which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process. RESULTS AND CONCLUSION:In the process of efferocytosis,the"Find me"and"Eat me"processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the"Find me"and"Eat me"factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most"Find me,""Eat me"and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of"Find me"and"Eat me"factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.

Infancy is a critical period for children's growth and development. During this period，the reasonable increase of fat mass percentage and fat mass index is very important for children's healthy growth. However，excessive increases in fat mass percentage and fat mass index may increase the risk of metabolic related diseases. In China，the research field of body composition in infants is still in the development stage，and the relevant research results and literature are relatively few. This article summarizes the domestic and foreign research on infant body composition，including application techniques，influencing factors and application significance，so as to provide reference for the formulation of domestic infant body composition reference standards and related clinical and scientific research work.

Objective To explore the effect of vaginal sacrospinous ligament suspension(VSSLS)with uterus preservation in treatment of patients with moderate to severe pelvic organ pro-lapse(POP).Methods A total of 92 patients with moderate to severe POP were randomly divided into control group and observation group,with 46 cases in each group.The control group received va-ginal anterior and posterior wall repair(VAPWR),while the observation group underwent VSSLS.The intraoperative blood loss,operation time and hospital stay were compared between the two groups;the Pelvic Floor Distress Inventory-20(PFDI-20)was used to evaluate quality of life;the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12(PISQ-12)was used to assess conditions of sexual satisfaction degree,dyspareunia,sexual frequency,and perceived control during sexual activi-ty;surgical complications in both groups were recorded.Results The observation group had less intr-aoperative blood loss,shorter operation time,and shorter hospital stay compared with the control group(P＜0.01).After treatment,the observation group had lower scores in all dimensions of the PFDI-20 compared with the control group,and the decreasing range was significantly greater than that in the control group(P＜0.01).After treatment,the observation group had significant higher scores for sex-ual satisfaction degree,sexual frequency and perceived control during sexual activity compared with the control group,and the change in these indicators before and after treatment was also significantly greater in the observation group,while the score for dyspareunia was significantly lower in the observation group,with a significant decrease compared with the control group(P＜0.01).The incidence of complications was significantly lower in the observation group than that in the control group(P＜0.01).Conclusion As a surgical approach for the treatment of moderate to severe POP,VSSLS can significantly improve patient's quality of life.

Objective To compare the application value of indocyanine green(ICG),nano-car-bon,methylene blue(MB)tracing methods,and ICG combined with nano-carbon tracing method in laparoscopic surgery for stage Ⅰ to Ⅱ endometrial cancer according to International Federation of Gynecology and Obstetrics(FIGO)staging system.Methods A retrospective selection of 92 pa-tients who underwent laparoscopic surgery for stage Ⅰ to Ⅱ endometrial cancer was conducted.Based on intraoperative sentinel lymph node(SLN)tracing method,the patients were divided into ICG group(n=24,using ICG tracing method),nano-carbon group(n=22,using nano-carbon tracing meth-od),MB group(n=23,using MB tracing method),and combined group(n=23,using ICG combined with nano-carbon tracing method).Surgical-related indicators,pathological results,and the incidence of complications were compared among the four groups.The detection efficacy of different tracing methods was also compared,using pathological results of surgical specimens as the gold standard.Results There were no statistically significant differences in the SLN resection time,to-tal operative time,and intraoperative blood loss among the four groups(P＞0.05).The number of lymph nodes resected intraoperatively in the combined group was significantly higher than that in the other three groups(P＜0.05).There were no statistically significant differences in the pathological results of surgical specimens(tumor invasion depth＞50％,tumor diameter＞2 cm,tumor invasion of the cervix or lymphovascular space)among four groups(P＞0.05).The complication rates in the ICG group,nano-carbon group,MB group,and combined group were 4.17％,9.09％,8.70％,and 13.04％,respectively,with no statistically significant difference(P＞0.05).Using the pathological results of surgical specimens as the gold standard,the detection accuracy,sensitivi-ty,and specificity of ICG combined with nano-carbon tracing method for SLNs in patients with stage Ⅰto Ⅱ endometrial cancer were 86.96％,90.00％,and 66.67％,respectively.The positive predictive value and negative predictive value were 94.74％and 50.00％,respectively.The detection efficacy of this combined method was higher than that of the other three methods.Conclusion Compared with the ICG,nano-carbon,and MB tracing method,ICG combined with nano-carbon tracing method has a higher application value in laparoscopic surgery for stage Ⅰ toⅡ endometrial cancer.It can accurately i-dentify the status of lymph node metastasis,with a moderate price and simple operation.

Objective To explore the correlation between cardiac remodeling and the occurrence of contrast-associated acute kidney injury(CA-AKI)assessed by echocardiography.Methods A retrospective analysis was conducted on the clinical data of 100 patients with coronary artery disease(CAD)who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from March 2021 to March 2024.The patients were divided into CA-AKI group and non-CA-AKI group according to whether CA-AKI occurred.Baseline data and echocardiographic parameters,inclu-ding left ventricular end-diastolic internal diameter index(LVIDDI),left ventricular end-systolic in-ternal diameter index(LVIDSI),and left ventricular mass index(LVMI),were collected and com-pared between the two groups.Logistic regression analysis was used to screen for independent influen-cing factors of CA-AKI occurrence.Results The level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the CA-AKI group was higher than that in the non-CA-AKI group,and the difference was statistically significant(P＜0.001).Compared with the non-CA-AKI group,the CA-AKI group had higher levels of C-reactive protein and glycosylated hemoglobin(HbA1c),as well as a higher proportion of patients with diabetes and anemia,and the differences were statistically significant(P＜0.05).Echocardiographic data showed that LVMI,LVIDDI,and LVIDSI in the CA-AKI group were all higher than those in the non-CA-AKI group,and the differences were statistically sig-nificant(t=2.057,3.429,2.975;P＜0.05).The left ventricular ejection fraction(LVEF)level in the CA-AKI group was lower than that in the non-CA-AKI group,and the difference was statisti-cally significant(t=3.005,P=0.003).Univariate Logistic regression analysis showed that diabe-tes,anemia,inflammation,NT-proBNP,HbA1c,LVMI,LVIDDI,LVIDSI,LVEF,ventricular hy-pertrophy,and ventricular dilation were significantly associated with the occurrence of CA-AKI(P＜0.05).Multivariate Logistic regression analysis results showed that LVMI(OR=3.81;95％CI,1.04 to 8.50;P=0.045),LVIDDI(OR=4.21;95％CI,2.02 to 6.08;P＜0.001),LVIDSI(OR=1.61;95％CI,1.27 to 2.03;P=0.024),ventricular hypertrophy(OR=3.42;95％CI,1.83 to 4.44;P=0.001),and ventricular dilation(OR=2.93;95％CI,1.43 to 3.74;P=0.033)were independent influencing factors for the occurrence of CA-AKI.Conclusion Cardiac remodeling is significantly correlated with the risk of CA-AKI in CAD patients.Clinicians should take protective measures timely for patients with abnormal cardiac structure to prevent the occurrence of CA-AKI.

ObjectiveTo establish consensus on Chinese Herbal Medicine (CHM) for rheumatoid arthritis (RA) among 21 Singaporean experts, this study addressed the lack of CHM clinical practice guidelines (CPGs) in Singapore. Despite advancements in RA therapies, the disease's progressive nature and high costs of novel treatments worsen disparities in management and outcomes. The initiative aimed to bridge this gap by developing expert-backed recommendations for CHM use in RA care.MethodsThe group of experts conducted two rounds of Delphi surveys containing 29 items identified from a literature review. Consensus was defined as ≥75% of votes in dichotomized ratings on a five-point ordinal scale for recognition. Items that did not reach consensus were discussed in a focus group with four selected experts.ResultsNineteen experts completed both rounds of Delphi surveys. A consensus was reached for 27 items, which encompassed Chinese medicine rationale, pattern differentiation, management, CHM prescription, and co-effectiveness with pharmacological therapy. Collective expert opinions were formed for the two remaining items. All items received a recognition score 3.5.ConclusionsThe consensus derived from this study provides a foundation for CHM CPGs for RA in Singapore. However, the findings are limited by the demographic composition of the experts and the representativeness of the patient pool.

Tuberous sclerosis complex(TSC)is a rare genetic disease that can lead to benign dysplasia in multiple organs such as the skin, brain, eyes, oral cavity, heart, lungs, kidneys, liver, and bones. Its main symptoms include epilepsy, intellectual disabilities, skin depigmentation, and facial angiofibromas, whilst incidence is approximately 1 in 10 000 to 1 in 6000 newborns. This case presents a middle-aged woman who initially manifested with epilepsy and nodular depigmentation. Later, she developed a lower abdominal mass, elevated creatinine, and severe anemia. Based on clinical features and whole exome sequencing, the primary diagnosis was confirmed as TSC. Laboratory and imaging examinations revealed that the lower abdominal mass originated from the uterus. CT-guided biopsy pathology and surgical pathology suggested a combination of leiomyoma and abscess. With the involvement of multiple organs and various complications beyond the main diagnosis, the diagnostic and therapeutic process for this patient highlights the importance of rigorous clinical thinking and multidisciplinary collaboration in the diagnosis and treatment of rare and challenging diseases.

Schimke immuno-osseous dysplasia (SIOD)caused by SMARCAL1 gene mutations is a rare genetic disorder characterized by multi-system involvement, including T-cell dysfunction, skeletal dysplasia, disproportionate short stature, nephrotic syndrome, and kidney failure. This multidisciplinary consultation involved a 9-year-old boy with intrauterine growth retardation, presenting with short stature, T-cell lymphopenia, proteinuria, and degenerative bone and joint disease. Treatment primarily focused on symptomatic and supportive care. Through the multidisciplinary rare disease consultation, holistic support was provided to the patient, offering comprehensive care from various specialtiesx.We also aim to use this case report to enhance clinicians′ under-standing of SIOD and improve the management and treatment of rare diseases.

Objective: To assess the nutritional status of primary and secondary school students in Beijing City and to analyze the related factors, so as to provide a scientific basis for improving the nutritional status of primary and secondary school students in a targeted manner. Methods: Based on the 2021 Beijing Student Common Diseases and Health Influencing Factors Surveillance Project, a stratified random cluster sampling method was used to conduct a physical examination and questionnaire survey on 25 487 primary and secondary school students from September to November 2021. The Chi square test was used for comparison of nutritional status detection rates, and disordered multi classification Logistic regression analysis was used to explore the factors associated with students nutritional status. Results: The detection rates of malnutrition, overweight and obesity among primary and secondary school students in Beijing City were 4.7%, 18.0% and 23.8% respectively. The detection rates of malnutrition, overweight and obesity were higher among male students (5.1%, 20.4%, 29.7%) than female students (4.2%, 15.5%, 17.4%) ( χ 2= 12.23, 101.71, 526.99, P <0.01). The detection rate of obesity was higher in the suburbs than urban areas(26.6%, 19.8%), and the detection rate of malnutrition was lower in the suburbs than urban areas (4.2%,5.5%)( χ 2=157.25, 23.61, P <0.01). The results of disordered multi classification Logistic regression showed that the related factors for malnutrition, overweight and obesity were gender, residence, moderate to vigorous exercise ≥60 min per day and lack of sleep( OR =1.70, 1.88,2.48; 1.14, 0.87, 0.67; 0.85, 0.92, 0.81 ; 0.83, 1.08, 1.07); frequency of fried food intake daily was a related factor for overweight ( OR =0.70); whether eating breakfast daily or not was a related factor for overweight and obesity ( OR =0.91, 0.84); academic level (middle and high school) was a related factor for malnutrition and obesity ( OR =1.38, 1.37; 0.77, 1.40)( P <0.05). Conclusions The problem of overweight and obesity among primary and secondary school students in Beijing City continues to be serious, especially among boys and suburban areas. It is recommended that society, schools, families and individuals should work together to improve the nutritional status of primary and secondary school students by adopting a graded and classified approach.

Objective:Investigating the changes of phenotype and moleculars associated with aging with the increase of passage times of human dental pulp stem cells (hDPSC), to explore the role of WW-containing transcriptional regulator 1 (WWTR1) in the aging mechanism.Methods:hDPSCs were cultured by tissue block method, and were divided into 4 groups according to the age, algebra, cell knockdown and overexpression of WWTR1 in hDPSCs. Group Ⅰ: hDPSCs from human teeth were further divided into youth group (15-25 years old) and group middle-aged group (40-50 years old) according to different ages. Group Ⅱ: according to different passage, hDPSCs were divided into young cells group (hDPSCs were transmitted to P3 generation), and old cells group (hDPSCs were transmitted to P10 generation). Group Ⅲ: hDPSCs were knocked down of WWTR1, which were further divided into knockdown group and knockdown carrier group. Group Ⅳ: hDPSCs were overexpressed of WWTR1, which were further divided into overexpression group and overexpression carrier group. Real-time fluorescence quantitative PCR (RT-qPCR) was used to detect the changes of WWTR1 expression in groups Ⅰ and Ⅱ, and cell counting kit-8 (CCK-8) was used for groups Ⅱ, Ⅲ, and Ⅳ. Cell proliferation capacity was detected by CCK-8 assay. The ability of osteogenic differentiation was detected by alizarin red staining. Cell senescence positive rate was detected by age-related β-galactosidase staining. The expression levels of age-related genes p53 and p21 were detected by RT-qPCR.Results:The proportion of senescent cells increased gradually with continuous culture. The proliferation and osteogenic differentiation of hDPSCs in the old group were significantly lower than those in the young group ( P<0.001). The expression levels of senescence related genes p53 (2.09±0.24) and p21 (4.91±0.54) in old cell group were higher than those in young cell group respectively [p53: (1.08±0.09) and p21: (1.09±0.08)] ( P<0.01, P<0.001). The WWTR1 expression levels of hDPSCs in middle-aged group and old cells group were both decreased compared with those in young group and young cells group ( P<0.01). The proportion of senescent cells in knockdown group (44.50±2.42) was higher than that in knockdown carrier group (22.27±0.56) ( P<0.001). After knocking down WWTR1 in hDPSCs, the expression levels of age-related genes p53 and p21 were up-regulated ( P<0.001), and the abilities of proliferation and osteogenic differentiation in the knockdown group were lower than those in the knockdown carrier group ( P<0.001). The proportion of senescent cells in overexpression empty carrier group (20.40±0.79) was higher than that in overexpression group (10.07±0.61) ( P<0.001). After WWTR1 overexpression ins hDPSCs, the expression levels of age-related genes p53 and p21 were down-regulated, and the proliferation and osteogenic differentiation ability in overexpression group were higher than those in overexpression carrier group ( P<0.001). Conclusions:WWTR1 can inhibit the expression levels of age-related genes p53 and p21, thus delaying the aging process as well as promoting the proliferation and osteogenic differentiation of hDPSCs.