As a chronic and complex disease,obesity can cause many other diseases.Obesity is influenced by many factors.At present,the main treatment methods for obesity are behavioral intervention,medication,endoscopic therapy,and sleeve gastrectomy.New break-throughs and progress have achieved in medication.This article mainly introduces the latest clinical situation and adverse reactions of several representative drugs in glucagon-like peptide-1 receptor agonists,such as liraglutide,semaglutide,and tirzepatide.This article mainly aims to analyze the safety and efficacy of these anti-obesity drugs and provide guidance for future clinical medication.

The gut microbiota plays a crucial role in regulating energy metabolism and obesity progression through mechanisms involving short-chain fatty acid and bile acid metabolism pathways. Obese individuals often exhibit gut microbiota dysbiosis, which can influence lipid metabolism and insulin sensitivity through microbial metabolites and signaling mechanisms. Dietary, pharmaceutical, and bariatric metabolism surgery can modulate the gut microbial, strongly correlating with weight reduction and metabolic benefits. Emerging microbiome-modulating strategies, such as probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, can restore microbial homeostasis and improve bile acid processing, but results differ among people. Moreover, the structural specificity of dietary fibers enables targeted microbial modulation, which provide new perspectives for developing anti-obesity therapies. This review summarizes the mechanisms of interaction between gut microbiota and the host and the clinical research progress in obesity intervention.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

Objectives:To conduct an optimizing blood transfusion process for severe trauma patients in the emergency department and investigate its effectiveness.Methods:Based on the current situation and analysis of the reasons for the current blood transfusion preparation practices for severely injured patients, the optimization was carried out in three aspects: the medical treatment process, departmental responsibilities, and the blood transfusion process. The differences in the key time links of emergency blood transfusion were compared between 40 patients with severe trauma treated by traditional protocols (July-August 2022) and 40 patients treated by optimized process (April 2023) and the treatment effects were also investigated. T-tests were used to compare the key time links, and chi-square tests were used to compare the rates of successful resuscitation before and after optimization.Results:(1) Following process optimization, the average emergency department blood transfusion preparation time for severe trauma patients was significantly reduced compared with the traditional process [(28.40 ± 2.72) min vs. (64.83 ± 11.57) min, P<0.01]. (2) Average blood sample submission time decreased from (20.83 ± 7.88) min to (7.80 ± 1.59) min, and average blood retrieval time decreased from (15.08 ± 5.72) min to (8.10 ± 2.30) min, both with P<0.01. (3) Optimized procedures resulted in a reduction of resuscitation room stay time from (410.40 ± 157.69) min to (337.15 ± 74.09) min ( P<0.01). (4) Post-optimization, the Intensive Care Unit (ICU) length of stay for successfully resuscitated patients was significantly shorter [(13.54 ± 4.82) days vs. (16.61 ± 6.08) days, P<0.05]. Conclusions:Through process optimization, the blood transfusion process for severe trauma emergency patients is further standardized, reducing delays at each stage and improving both transfusion and treatment efficiency.

Obesity is an independent risk factor for many chronic diseases, which seriously affects the quality of life and physical and mental health of patients, and is a serious public health problem facing society. Obesity research is the focus and difficulty of current medical research. At present, laparoscopic sleeve gastrectomy and gastric bypass surgery have become important ways to treat obesity, but the specific mechanism is still unclear. In recent years, research on obesity-related genes has made certain progress. The link between surgery and obesity gene expression is gradually being discovered. Different gene functions such as energy intake and consumption and fat storage by fat cells have also derived different treatment methods. This article will summarize the research on obesity genes.

The number of women of childbearing age having overweight or obesity problems keeps increasing globally. Besides diabetes, hypertension and other chronic conditions, these women may develop metabolic disorders of sex hormones, manifested by irregular menstruation, infertility and obstetric complications. Bariatric surgery offers prominent weight loss and improves obesity-related conditions. Women patients also benefit from elevated chances of pregnancy postoperatively. However, the timing of pregnancy for obese women after surgery has impact on the effects of weight loss surgery, pregnancy complications, delivery outcomes and long-term prospects of mother and child. This article reviews the clinical studies on the timing of pregnancies after bariatric surgery, weight loss results, as well as risks and outcomes.

Osteoporosis is a chronic disease influenced by multiple factors.The fractures associated with osteoporosis are known as osteoporotic fractures.The factors associated with osteoporosis and fracture include oxygen concentration,sunshine,body mass,gender,age,trauma,dietary habits,tobacco and alcohol use,medical history and inheritance.Factors such as oxygen concentration,topography and dietary habits play a more important role in the western plateau areas in China than in the plain areas.The present study reviews the clinical research on the osteoporosis and fracture risks in the plateau areas in China and proposes prevention and treatment measurements for the risk factors to reduce the incidences of osteoporosis and fracture in the plateau areas.

Objective To investigate the condition and causes of needle-stick injuries among health care workers(HCWs), and explore effective strategies for preventing needle-stick injuries.Methods Needle-stick injuries recorded by healthcare-associated infection management department in a hospital between January 2013 and December 2015 were surveyed retrospectively.Results 164 HCWs suffered needle-stick injuries, including 71 (43.29%) doctors, 81 (49.39%) nurses, and 12 (7.32%) other HCWs.The number of injuries in 2013, 2014, and 2015 were 47(28.66%), 54(32.93%),and 63(38.41%)respectively.152(92.68%), 9(5.49%),and 3(1.83%)injuries were caused by contaminated medical instruments, uncertain-contaminated medical instruments, and non-contaminated medical instruments.Among 164 cases of needle-stick injuries, 67(40.85%) occurred in operating rooms, 141 (85.98%) were finger injuries;the main causes of needle stick injuries were carelessness, busy work and nonstandard manipulation(n=115, 70.12%), most doctors suffered needle stick injuries due to the lack of experience (52.11%), most nurses suffered needle stick injuries due to carelessness, busy work and nonstandard manipulation(93.83%).Conclusion Needle stick injuries among HCWs increased year by year, strategies should be implemented to reduce the occurrence of needle injuries, including strengthening occupational protection consciousness among HCWs, strengthening construction of healthcare-associated infection management system, and improving medical environment.

Background:Helicobacter pylori(Hp)is an important pathogen for peptic ulcer and gastric cancer,and is reportedly associated with a variety of extragastrointestinal diseases. However,there is no body fluid detection technique for Hp infection in clinical practice. Aims:To identify Hp infection-associated differentially expressed proteins in urine with relative molecular mass more than 10 kDa and provide potential biomarkers for diagnosis of Hp infection through body fluid detection. Methods:Midstream urine was collected from volunteers in the morning,and 13 C-urea breath test was performed to determine Hp infection. Each of 15 Hp-negative and 15 Hp-positive urine samples were mixed respectively for protein extraction. Spectra data were acquired by high performance liquid chromatogram-mass spectrometry,and label-free technology was used for relative quantitative analysis. The other 26 urine samples(15 Hp-negative and 11 Hp-positive) were used for validation by full scan. IPA software was employed for bioinformatics analysis. Results:A total of 475 urinary proteins were detected by label-free quantitative analysis and 42 differentially expressed proteins were identified. Finally,11 significantly up-regulated differentially expressed proteins were confirmed by external scanning validation. Bioinformatics analysis revealed the molecular functions,biological pathways,and related diseases of these differentially expressed proteins. Conclusions:These 11 differentially expressed proteins more than 10 kDa identified in urine might be potential biomarkers for diagnosis of Hp infection and provide molecular evidence for the correlation of Hp infection with extragastrointestinal diseases.

Objective To investigate the clinical therapeutic effect of mild hypothermia in elderly patients with severe traumatic brain injury.Methods 72 cases of elderly patients with severe traumatic brain injury(GCS ≤ 8) were divided into mild hypothermia therapy group(36 patients)and control group(36 patients) according to the random number table method.Mild hypothermia therapy group received mild hypothermia treatment while control group received normal treatment.The clinical prognosis was analyzed between the two groups.Results After 24h treatment,both mild hypothermia therapy group and control group intracranial pressure began to rise.But the intracranial pressure of the mild hypothermia therapy group(24 h:(13.0±4.5)mmHg,3 d:(16.6±4.0) mmHg,5 d:(19.9±3.9) mmHg,1 mmHg=0.133 kPa) were significantly lower than those of the control group (24 h:(16.6± 3.8) mmHg,3 d:(20.4±4.8) mmHg;5 d:(24.1 ± 6.2) mmHg),and the difference was statistically significant (t=2.225,2.260,2.192,P=0.035,0.033,0.039).The rate of good recovery to the control group and the mild hypothermia therapy group were 22.22％ and 47.22％ respectively while the mortality were 30.56％ and 13.89％ respectively,and the differences were statistically significant (x2 =4.936,5.675,P=0.047,0.035).Conclusion Mild hypothermia treatment can inhibit the increase of intracranial pressure and reduce disability rate and mortality in elderly patients with severe traumatic brain injury,which can increase the survival rate and improve the long-term prognosis.