Objective To evaluate the association of different obesity phenotypes and their components with the risk of cognitive impairment in older Chinese adults,and to assess the association between obesity and cognitive impairment in different cognition-related genetic backgrounds.Methods A cross-sectional study based on the West China Health and Aging Cohort was conducted.Logistic regression was applied to estimate the association of obesity phenotypes and components with cognitive impairment in older Chinese adults stratified by APOE gene and polygenic risk scores.Results A total of 7 316 participants were enrolled,of whom 1 820 had cognitive impairment.Weight gains were associated with a reduced risk of cognitive impairment(odds ratio[OR]=0.96,95%CI,0.95-0.97).Being overweight with a normal waist-to-hip ratio was a protective factor for cognition(OR=0.74,95%CI,0.61-0.90),whereas the coexistence of elevated waist-to-hip ratio and overweight did not increase the risk of cognitive impairment.Sarcopenia was associated with an elevated risk of cognitive impairment.This association was found in both overweight(OR=2.03,95%CI,1.71-2.41)and non-overweight older adults(OR=1.86,95%CI,1.58-2.20),and was significant across all polygenic risk score strata.Conclusion Increasing body mass may serve as a key protective factor against cognitive decline in older adults.Having sarcopenia and obesity is associated with an elevated risk of cognitive impairment,independent of genetic susceptibility.

Objective To construct a differential diagnosis model for systemic lupus erythematosus(SLE)from other autoimmune diseases based on the conventional test indicators in clinical laboratory,so as to improve the diagnostic efficacy of the existing test indicators.Methods The data of 178 SLE patients(SLE group)and 196 patients with other autoimmune diseases(control group)diagnosed in Sichuan Provincial People's Hospital from Apr.2022 to Mar.2023 were retrospectively analyzed.The differences in the levels of 19 clinical routine indicators between the 2 groups were analyzed.The least absolute shrinkage and selection operator(LASSO)regression was used to screen for test indicators with non-zero coefficients.These indicators were then used in logistic regression to construct a Nomogram model for SLE differential diagnosis.Model performance was assessed using receiver operating characteristic(ROC)curves and decision curve analysis.Results The levels of anti-cardiolipin antibody immunoglobulin(Ig)G,anti-cardiolipin antibody IgA,high-sensitivity C reactive protein(hs-CRP),D-dimer,and thrombin time(TT)in the SLE group were significantly higher than those in the control group(all P＜0.05),while the levels of IgM,complement 3(C3),complement 4(C4),prothrombin time(PT),and activated partial thromboplastin time(APTT)in the SLE group were significantly lower than those in the control group(all P＜0.05).Through LASSO regression,IgM,C3 and C4 were selected as the most likely indicators with non-zero coefficients.Multivariate logistic regression analysis showed that the differential diagnosis model was Logit P=4.18-1.34 × IgM-1.70 × C3-6.61 × C4.The area under the curve of this model was 0.80(95％confidence interval 0.76-0.85),with a sensitivity of 0.77 and a specificity of 0.74.Decision curve analysis demonstrated favourable clinical utility within a threshold probability range of 0.2-0.9.Conclusion The present model,constructed using the clinical routine indicators,such as IgM,C3 and C4,is helpful for the differential diagnosis of SLE from other autoimmune diseases and has good clinical application value.

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.

The patient was admitted to the hospital with a diagnosis of diffuse large B-cell lymphoma for one month,accompanied by limb numbness for one week.Upon admission,the patient was initially prescribed vitamin B,and mecobalamin for symptomatic relief,which led to an improvement in the symptoms of limb numbness.Subsequently,the patient was administered chemotherapy consisting of rituximab,lenalidomide,and prednisone.However,following the initiation of chemotherapy,the symptoms of limb numbness became more severe.After review of the patient's medication history and analysis of relevant data,the clinical pharmacist suggested that the patient's limb numbness was caused by lenalidomide-induced peripheral neuropathy.

The patient was admitted to the hospital with a diagnosis of diffuse large B-cell lymphoma for one month,accompanied by limb numbness for one week.Upon admission,the patient was initially prescribed vitamin B,and mecobalamin for symptomatic relief,which led to an improvement in the symptoms of limb numbness.Subsequently,the patient was administered chemotherapy consisting of rituximab,lenalidomide,and prednisone.However,following the initiation of chemotherapy,the symptoms of limb numbness became more severe.After review of the patient's medication history and analysis of relevant data,the clinical pharmacist suggested that the patient's limb numbness was caused by lenalidomide-induced peripheral neuropathy.

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 compare the effects of the modified lytic cocktail and the classic lytic cocktail on organ function of severely scalded rats.Methods:The experimental study method was applied. Twenty-four about 10-week-old male Sprague-Dawley rats were assigned into sham injury group, scald alone group, classic lytic cocktail group, and modified lytic cocktail group according to the random number table, with 6 rats in each group. In scald alone group, classic lytic cocktail group, and modified lytic cocktail group, rats were subjected to a 30% total body surface area (TBSA) full-thickness scald on the back. Rats in sham injury group underwent a simulated injury process to mimic a sham injury. Immediately after injury, rats in classic lytic cocktail group were intraperitoneally injected with a classic lytic cocktail (12 mL/kg) consisting of pethidine, chlorpromazine, and promethazine, supplemented with gavage using normal saline; and rats in modified lytic cocktail group were intraperitoneally injected with a mixed drug (2 mL/kg) consisting of midazolam and fentanyl, supplemented with gavage using cetirizine. Subsequently, rats in four groups were all intraperitoneally injected with lactated Ringer's solution for fluid resuscitation, with a total fluid and administration volume of 2 mL·kg -1·TBSA -1. On the following day, rats in the two lytic cocktail groups were administered medication once again as above. On post injury day (PID) 3, the abdominal aortic blood, liver, small intestine, and lung tissue were collected from rats in each group. The plasma levels of interleukin-1β (IL-1β), IL-10, and IL-6 were measured using an enzyme-linked immunosorbent assay. The plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (γ-GT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), LDH isoenzyme 1 (LDH-1), creatine kinase (CK), CK isoenzyme (CK-MB), urea, creatinine, and uric acid were detected using an automated biochemical analyzer. The histological changes of liver, small intestine, and lung tissue were observed after performing hematoxylin and eosin staining. Data were statistically analyzed with one-way analysis of variance and Tukey's test. Results:On PID 3, the plasma level of IL-10 of rats in classic lytic cocktail group was (44±16) pg/mL, which was significantly higher than (20±9) pg/mL in modified lytic cocktail group and (21±6) pg/mL in scald alone group (with P values all <0.05); there was no statistically significant difference in the plasma levels of IL-1β or IL-6 of rats among the four groups ( P>0.05). On PID 3, the plasma levels of ALT and AST of rats in scald alone group were (77±14) and (213±65) U/L, respectively, which were significantly higher than (59±5) and (108±10) U/L in sham injury group ( P<0.05); the plasma levels of ALT and AST in modified lytic cocktail group were (61±3) and (116±11) U/L, respectively, which were significantly lower than (81±13) and (207±54) U/L in classic lytic cocktail group ( P<0.05); the plasma level of AST of rats in modified lytic cocktail group was significantly lower than that in scald alone group ( P<0.05). On PID 3, there was no statistically significant difference in the plasma levels of γ-GT, ALP, LDH, LDH-1, CK, CK-MB, creatinine, or uric acid of rats among the four groups ( P>0.05); although there was a statistically significant overall difference in the plasma level of urea of rats among the four groups ( P<0.05), the comparisons between scald alone group and each of sham injury group, classic lytic cocktail group, and modified lytic cocktail group, and the comparison between classic lytic cocktail group and modified lytic cocktail group showed no statistically significant differences ( P>0.05). On PID 3, compared with those in sham injury group, rats in scald alone group exhibited diffuse microvesicular and vacuolar degeneration of hepatocytes in liver tissue, noticeable loose edema in the villous stroma in small intestine tissue, and significantly widened alveolar septa in large area of lung tissue. Compared with those in scald alone group, rats in the two lytic cocktail groups showed alleviated hepatocellular steatosis and vacuolar degeneration, relieved thickening of alveolar walls and edema in the villous stroma of the intestine. The histopathological manifestations of organs in rats of modified lytic cocktail group were closer to those in sham injury group. Conclusions:The classic lytic cocktail may have a stronger anti-inflammatory effect, while the modified lytic cocktail exhibits better protection of liver function, but both of the two lytic cocktails can alleviate the histopathological injury of the liver, lungs, and small intestine in severely scalded rats. For the liver, lungs, and small intestine, the modified lytic cocktail provides organ protection comparable to that of the classic lytic cocktail.

Objective:To analyze the correlation between the root resorption rate and tooth movement of the maxillary and mandibular incisors before and after orthodontic treatment in adult patients using cone-beam CT (CBCT), and to explore the related factors that affect the apical root resorption.Methods:In this retrospective study, 23 adult patients with classⅠor class Ⅱ division 1 malocclusion [2 males and 21 females, mean age (23.4±6.3) years, treatment time (2.1±0.7) years] who received orthodontic treatment with fixed appliance in Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People′s Hospital from January 2017 to June 2021 were enrolled. Full-column CBCT examination was performed before and after treatment. A three-dimensional model was established to observe and record the volume of the maxillary and mandibular central and lateral incisors before and after treatment. The change of the incisal edge, the angle of rotation of the incisal edge, and the direction of the long axis of the tooth were also measured. The root resorption in each tooth before and after treatment was compared, and the root resorption rate was calculated. Pearson correlation analysis was performed on the root absorption rate before and after treatment with age, treatment time and tooth movement.Results:After treatment, the tooth volume of the maxillary and mandibular central and lateral incisors decreased significantly ( P<0.01). The root absorption volumes were (20.2±6.0) mm 3 and (11.2±4.7) mm 3 in maxillary central and lateral incisors, and (14.7±4.6) mm 3 and (14.8±5.0) mm 3 in mandibular central and lateral incisors, respectively. The root absorption rates were (9.49±1.75)% and (9.13±3.24)% in maxillary central and lateral incisors, and (8.56±3.43)% and (9.65±2.76)%, in mandibular central and lateral incisors, respectively ( F=0.56, P=0.640). The root resorption rate of maxillary central incisors had a weak positive correlation with the change of sagittal distance of incisal edge ( r=0.36, P=0.015). The root resorption rate of mandibular central incisors had a moderate positive correlation with the vertical movement distance ( r=0.48, P=0.001). The root resorption rate of mandibular lateral incisors was weakly positively correlated with the vertical movement of incisal edge and the treatment time ( r=0.35, P=0.016; r=0.34, P=0.021), and was moderately positively correlated wit the change of sagittal movement of incisal edge ( r=0.44, P=0.002). Conclusions:During orthodontic treatment, both maxillary and mandibular incisors had a certain degree of root resorption, which was related to sagittal and vertical movement of the incisors and the time of orthodontic treatment.

Objective:To evaluate the outcomes of endoscopic resection of symptomatic talocalcaneal coalitions in adolescents using a posterior approach.Methods:A retrospective case-series study was performed to analyze the data of 15 adolescent patients (16 feet) with symptomatic talocalcaneal coalitions (TCC) who had been treated by posterior arthroscopy from February 2017 to December 2020 at Department of Orthopaedics, Xuzhou Central Hospital. There were 11 boys and 4 girls with an average of 14.3 years (from 11 to 17 years). The left side was affected in 9 and the right side in 5 patients, and both sides were involved in one. Ten patients had a history of ankle sprain. The clinical outcomes were evaluated by visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and 36-item short form health survey (SF-36) postoperatively.Results:The 15 patients were followed up for a mean time of 19.9 months (from 12 to 36 months). At the final follow-up, the VAS significantly decreased from preoperative 6 (6, 7) points to 1 (1, 3) point, the AOFAS ankle-hindfoot score significantly increased from preoperative (54.1±10.4) points to (90.0±16.6) points, and the SF-36 score significantly improved from preoperative (55.5±12.7) points to (88.7±6.5) points ( P<0.05). Follow-ups found such complications as infection, TCC recurrence or osteoarthritis in none of the patients. Conclusion:Endoscopic TCC resection using a posterior approach is an effective surgery for symptomatic TCC in adolescents, showing advantages of limited invasion, fast recovery, a low rate of postoperative complications and precise resection.

Objective:To analyze the effects of hyperbaric oxygen（HBO）as adjuvant therapy on primary nephrotic syndrome（PNS）and renal function.Methods:A total of 92 PNS patients admitted to the Linyi Central Hospital from January 2020 to June 2021 were selected and divided into control group（ n=46）and observation group（ n=46）according to different treatment methods. The control group was given conventional treatment，and the observation group was given HBO on this basis of the treatment in the control group. The changes in the blood lipid-related indexes，inflammatory factor levels，and renal function in the two groups were compared before and after treatment，and the incidence of complications and the clinical therapeutic effect after treatment were observed. Results:Before treatment，there were no significant difference in blood lipid-related indexes，inflammatory factor levels，or renal function indexes between the two groups. After treatment，the above-mentioned indexes in both groups were all improved. The levels of cholesterol（CHOL），triglyceride（TG），and the inflammatory factors including IL-1，IL-6，and TNF-α in the observation group were significantly lower than those in the control group（ P<0.05）. The total effective rate in the observation group［93.48%（43/46）］was higher than that in the control group［76.09%（35/46）］，with statistically significant difference（ P<0.05）. The incidence of complications in the observation group［4.35%（2/46）］was significantly lower than that in the control group［19.57%（9/46）］，with statistically significant difference（ P<0.05）. After treatment，the serum creatinine，urea nitrogen，and 24-hour urinary protein quantification in the observation group were lower than those in the control group，and the serum albumin level in the observation group was higher than that in the control group，and all the differences were statistically significant（ P<0.05）. Conclusion:HBO as adjuvant therapy can improve the clinical therapeutic effect and enhance renal function，by effectively reducing the blood lipid level and inflammatory response and reducing complications，which is worth further popularization in clinical practice.