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 construct an evaluation index system for risk cognition and protection capability of interns at department of radiology for ionizing radiation,and explore its value in assessing risk cognition and protection capability of interns at department of radiology for ionizing radiation.Methods:Guided by the Knowledge-Attitude-Practice(KAP)theory,the relevant literatures that were published between January 1,2014,and December 31,2024 were searched from Chinese and English databases included China National Knowledge Infrastructure(CNKI),Wanfang,VIP Chinese Scientific Journals Database(VIP)and PubMed by using keywords such as"intern,""ionizing radiation and protection,""teaching,""indicator,""Delphi method,"and"KAP theory".Preliminary evaluation indicators were drafted based on interviews with 10 staff at department of radiology of Peking University People's Hospital.The Delphi method involving 21 experts from different provinces and cities of China was conducted over two rounds to finalize the index system.An online questionnaire survey by using Questionnaire Star was adopted to distribute questionnaires with evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation,and a total of 50 interns at department of radiology from Heilongjiang,Beijing,and Guangdong were investigated by the questionnaire.Results:Both the response and validity rates of the expert inquiry letters of two rounds for evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation were 100%.Experts'authority coefficients of two rounds were respectively 0.910 and 0.928,and the coordination coefficients of experts'opinions were respectively 0.318 and 0.342.The finalized evaluation index system comprised of 3 first-level indicators(theoretical knowledge,safety culture of ionizing radiation,and operational behavior),and 10 second-level indicators,and 46 third-level indicators.The scores of interns at department of radiology for the survey questionnaire of risk knowledge and protection capability about ionizing radiation was(177.57±29.68 points),indicating they were moderate level for risk knowledge and protection capability about ionizing radiation.Conclusion:The evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation has higher scientific nature and reliability,which can provide references for assessing the relevant theoretical and operational capability of interns,and conducting training with target.

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 construct an evaluation index system for risk cognition and protection capability of interns at department of radiology for ionizing radiation,and explore its value in assessing risk cognition and protection capability of interns at department of radiology for ionizing radiation.Methods:Guided by the Knowledge-Attitude-Practice(KAP)theory,the relevant literatures that were published between January 1,2014,and December 31,2024 were searched from Chinese and English databases included China National Knowledge Infrastructure(CNKI),Wanfang,VIP Chinese Scientific Journals Database(VIP)and PubMed by using keywords such as"intern,""ionizing radiation and protection,""teaching,""indicator,""Delphi method,"and"KAP theory".Preliminary evaluation indicators were drafted based on interviews with 10 staff at department of radiology of Peking University People's Hospital.The Delphi method involving 21 experts from different provinces and cities of China was conducted over two rounds to finalize the index system.An online questionnaire survey by using Questionnaire Star was adopted to distribute questionnaires with evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation,and a total of 50 interns at department of radiology from Heilongjiang,Beijing,and Guangdong were investigated by the questionnaire.Results:Both the response and validity rates of the expert inquiry letters of two rounds for evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation were 100%.Experts'authority coefficients of two rounds were respectively 0.910 and 0.928,and the coordination coefficients of experts'opinions were respectively 0.318 and 0.342.The finalized evaluation index system comprised of 3 first-level indicators(theoretical knowledge,safety culture of ionizing radiation,and operational behavior),and 10 second-level indicators,and 46 third-level indicators.The scores of interns at department of radiology for the survey questionnaire of risk knowledge and protection capability about ionizing radiation was(177.57±29.68 points),indicating they were moderate level for risk knowledge and protection capability about ionizing radiation.Conclusion:The evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation has higher scientific nature and reliability,which can provide references for assessing the relevant theoretical and operational capability of interns,and conducting training with target.

Objective To analyze the clinical characteristics,treatment,and prognosis of immune checkpoint inhibitor-related diabetes mellitus(ICI-DM).Methods The clinical characteristics,laboratory examinations,treatment regimens,and follow-up outcomes of 10 ICI-DM patients who were diagnosed and treated in the First Medical Center of Chinese PLA General Hospital between July 2019 and December 2024 were retrospectively analyzed.Relevant literatures were retrieved from domestic and foreign databases such as PubMed,CNKI,and VIP.The clinical characteristics of ICI-DM were summarized based on the literature results.Results All 10 patients were PD-1 inhibitor users,including 5 males and 5 females,with a median age of 54.5(51.3,64.0)years and a body mass index(BMI)of(22.0±2.15)kg/m2.Among them,9 cases(90.0%)were fulminant type 1 diabetes mellitus(FT1DM);9 cases(90.0%)had a severity of adverse events reaching grade 3-4 according to the Common Terminology Criteria for adverse events(CTCAE).The median time from PD-1 inhibitor treatment to the occurrence of the classic diabetes symptoms referred to as"three more and one less"(polyuria,polydipsia,polyphagia,and weight loss)in all patients was 145.5(110.5,204.8)days,and the medication duration was 6.0(4.3,7.8)cycles.The average blood glucose level of the 10 patients at the time of consultation was 25.3(10.0-41.4)mmol/L,and the glycated hemoglobin(HbA1c)level was 8.0%(6.6%-10.9%).Eight patients had fasting and 2-hour C-peptide levels<0.1 ng/ml(fasting C-peptide from<0.010 to 0.067 ng/ml,2-hour C-peptide from<0.010 to 0.077 ng/ml).Nine of the 10 patients were negative for diabetes autoantibodies,while 1 was not tested.All 10 patients were successfully treated with insulin and other therapies.During the follow-up after discharge,all patients still relied on insulin treatment,and no significant recovery of pancreatic islet β cell function was observed compared with that at discharge.Literature review revealed that ICI-DM was more common in PD-1 inhibitor users,with clinical mainly manifested as diabetic ketoacidosis(DKA)(65.4%)and diabetic ketosis(13.1%).Patients had severely impaired pancreatic islet function and required long-term insulin treatment,and some cases were complicated by thyroid or pituitary dysfunction.Conclusions ICI-DM typically presents as FT1DM,often manifesting with DKA or diabetic ketosis at onset.It is characterized by severe and irreversible loss of pancreatic islet function,necessitating lifelong insulin therapy.To enable early detection and prompt treatment,close monitoring of blood glucose is essential during ICI treatment.

The interactions between microorganisms and medicinal plants are crucial to the quality improvement of medicinal plants. Medicinal plants attract microorganisms to colonize by secreting specific compounds and provide niche and nutrient support for these microorganisms, with a symbiotic network formed. These microorganisms grow in the rhizosphere, phyllosphere, and endophytic tissues of plants and significantly improve the growth performance and medicinal component accumulation of medicinal plants by promoting nutrient uptake, enhancing disease resistance, and regulating the synthesis of secondary metabolites. Microorganisms are also widely used in the ecological planting of medicinal plants, and the growth conditions of medicinal plants are optimized by simulating the microbial effects in the natural environment. The interactions between microorganisms and medicinal plants not only significantly improve the yield and quality of medicinal plants but also enhance their geoherbalism, which is in line with the concept of green agriculture and eco-friendly development. This study reviewed the research results on the interactions between medicinal plants and microorganisms in recent years and focused on the analysis of the great potential of microorganisms in optimizing the growth environment of medicinal plants, regulating the accumulation of secondary metabolites, inducing systemic resistance, and promoting the ecological planting of medicinal plants. It provides a scientific basis for the research on the interactions between medicinal plants and microorganisms, the research and development of microbial agents, and the application of microorganisms in the ecological planting of medicinal plants and is of great significance for the quality improvement of medicinal plants and the green and sustainable development of TCM resources.
Plants, Medicinal/metabolism* ; Bacteria/genetics* ; Symbiosis

Purpose: This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis. Methods: This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up. Results: No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered. Conclusion CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.

Objective To explore the intervention effect and mechanism of Zhiwei Fuwei pills on precancerous lesions of gastric cancer(PLGC)model rats based on hypoxia-inducible factor-1α(HIF-1α)/vascular endothelial growth factor(VEGF)signaling pathway.Methods PLGC model rats were established by the combination of N-methyl-N'-nitro-N-nitrosoguanidine and ammonia drinking,hunger and satiation disorder,ethanol gavage and ranitidine feeding,and were randomly divided into model group,control group and experimental-H,-M,-L groups,with 8 rats in each group.Another 8 healthy rats were selected as blank group.Experimental-H,-M,-L groups were given 1.67,0.84 and 0.42 g·kg-1 Zhiwei Fuwei pills solution by intragastric administration,respectively;control group was given 2.00 × 10-3g·kg-1 folic acid solution by intragastric administration;blank group and model group were given 0.9％NaCl by intragastric administration,once a day for 4 weeks.The structural changes of gastric microvessels were detected by transmission electron microscopy,and the expression levels of HIF-1α,VEGF,vascular endothelial growth factor receptor-2(VEGFR-2)and Angiopoietin-2(Ang-2)were detected by western blot.Results Compared with the model group,the abnormality of gastric microvascular structure in experimental-H,-M,-L groups was improved to some extent,and the effect of high dose experimental group was the most obvious.The relative expression levels of HIF-1 α protein in experimental-H,-M groups and control group,model group and blank group were 0.43±0.03,0.66±0.04,0.77±0.01,0.80±0.02 and 0.37±0.02;the relative expression levels of VEGF protein were 0.97±0.06,1.21±0.06,1.51±0.07,1.54±0.05 and 0.88±0.02;the relative expression levels of VEGFR-2 protein were 1.03±0.06,1.18±0.04,1.37±0.05,1.45±0.02 and 0.70±0.02;the relative expression levels of Ang-2 protein were 0.51±0.03,0.61±0.02,0.71±0.01,0.78±0.03 and 0.34±0.01,respectively.Compared with the model group,the above indexes in the experimental-H,-M groups were statistically significant(all P＜0.01).Conclusion Zhiwei Fuwei pills may inhibit the abnormal activation of HIF-1α/VEGF signaling pathway,improve hypoxia microenvironment,reduce angiogenesis,and then effectively interfere with the progression of PLGC.

Objective Tissue uptake and distribution of nano-/microplastics was studied at a single high dose by gavage in vivo.Methods Fluorescent microspheres (100 nm, 3 μm, and 10 μm) were given once at a dose of 200 mg/(kg·body weight). The fluorescence intensity (FI) in observed organs was measured using the IVIS Spectrum at 0.5, 1, 2, and 4 h after administration. Histopathology was performed to corroborate these findings.Results In the 100 nm group, the FI of the stomach and small intestine were highest at 0.5 h, and the FI of the large intestine, excrement, lung, kidney, liver, and skeletal muscles were highest at 4 h compared with the control group (P < 0.05). In the 3 μm group, the FI only increased in the lung at 2 h (P < 0.05). In the 10 μm group, the FI increased in the large intestine and excrement at 2 h, and in the kidney at 4 h (P < 0.05). The presence of nano-/microplastics in tissues was further verified by histopathology. The peak time of nanoplastic absorption in blood was confirmed.Conclusion Nanoplastics translocated rapidly to observed organs/tissues through blood circulation;however, only small amounts of MPs could penetrate the organs.

Hypertension and osteoporosis(OP)are common diseases in middle-aged and elderly people,and the number of patients with both diseases has gradually increased in recent years.Because the onset of the disease is hidden,it is easy to cause fractures and serious complications of heart,brain and kidney in the later stage,which not only seriously damages the quality of life of patients,but also increases the difficulty of clinical treatment.Therefore,it is particularly necessary to strengthen the research on this disease.More and more studies have found that the disorder of intestinal flora will lead to the occurrence of OP,while the intestinal flora of patients with hypertension is obviously out of balance.Therefore,this paper thinks that intestinal flora may be the key influencing factor of hypertension complicated with OP,and the imbalance of intestinal flora will lead to the imbalance of short-chain fatty acid metabolism,immune inflammatory reaction and increased sympathetic nerve activity,thus causing the imbalance of bone homeostasis and promoting the occurrence of OP.Therefore,it is suggested that regulating intestinal flora may be a new way to intervene hypertension complicated with OP.