Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To investigate the inhibitory effect of anlotinib combined with anti-PD1 antibody on a colon cancer mouse model,and to explore its possible mechanismfor remodeling the immune system and tumor microenvironment.Methods A BALB/c mouse model was established with colon cancer cells CT26,and the mice were divided randomly into four groups:the control group,the anlotinib group,anti-PD1 antibody group and anlotinib combined with anti-PD1 antibody group,with 6 mice in each.During the experiment,tumor volumes were measured every 2 days using a vernier caliper.After the experiment(on day 14),the weight of the tumors of mice in each group was measured.Flow cytometry was used to detect changes in the number of immune infiltrating cells in tumor tissues,including CD4+T cells,CD8+T cells,monocytic myeloid-derived suppressor cells(M-MDSCs),granulocytic myeloid-derived suppressor cells(G-MDSCs),and M2-type tumor-associated macrophages(M2-TAM).Furthermore,ELISA was employed to detect the levels of vascular endothelial growth factor(VEGF),interferon-γ(IFN-γ),interleukin-17(IL-17),and IL-10 in the serum of mice.Results Compared with the control group,the other three groups showed a decrease in the volume and weight of transplanted tumors in mice(P＜0.05),as well as decreased levels of cytokines VEGF,IL-10(P＜0.05),and IL-17(P＜0.01).Additionally,there was an increase in the level of IFN-γ(P＜0.05).In terms of the number of immune infiltrating cells,the number of M-MDSCs decreased in each treatment group compared to the control group,but without statistically significant difference(P＞0.05).In the combined group,the number of M2-type TAMs decreased compared to the control group and the anti-PD-1 antibody group(P＜0.05).Furthermore,flow cytometry results indicated that compared to the control group,the other three groups showed an increase in the number of CD8+T cells in mice(P＜0.05).The number of CD4+T cells decreased slightly compared to the other groups,but the statistically significant difference was only observed when compared to the anlotinib group(P＜0.05).Conclusion The combination ofanlotinib and anti-PD1 antibody may regulate the levels of cytokines VEGF,IFN-γ,IL-10,and IL-17,thereby influencing the number of immunosuppressive cells in the tumor microenvironment.The tumor microenvironment and immunity can also be improved,thus significantly inhibiting the growth ofmouse colonic transplant tumors.

Objective To analyze the blood lipid levels of patients with psoriasis vulgaris (PsV) in Qinghai, China, and their correlation with clinical features, lesion area and severity. Methods A retrospective analysis was performed on the data of 185 PsV patients (PsV group). Another 185 healthy individuals were randomly selected as control group. The comorbidity prevalence of psoriasis was compared between the two groups. The blood lipid levels, lesion area scores, lesion severity scores, Psoriasis Area and Severity Index (PASI) scores and Dermatology Life Quality Index (DLQI) scores were compared between PsV patients from high-altitude areas (>3 000 m) and those from relatively low-altitude areas (2 000 to 3 000 m). The influencing factors of dyslipidemia comorbidity in PsV patients from high-altitude areas were analyzed. Results The prevalence of hypertension, diabetes, fatty liver, dyslipidemia, obesity and hyperuricemia in the PsV group was higher than that in the control group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that body mass index (BMI) ≥25.0 kg/m², comorbidity with diabetes and history of alcohol consumption were risk factors for comorbid dyslipidemia in PsV patients from high-altitude areas (P < 0.05). The total serum cholesterol, low-density lipoprotein cholesterol (LDL-C), lesion area scores, lesion severity scores, PASI scores and DLQI scores were higher in PsV patients from high-altitude areas compared to those from relatively low-altitude areas, with statistically significant differences (P < 0.05). Conclusion There are significant differences in lesion area and severity among PsV patients from different altitudes and with different blood lipid levels. BMI≥25.0 kg/m², comorbidity with diabetes and history of alcohol consumption are risk factors for comorbid dyslipidemia in PsV patients from high-altitude areas.

Objective:To compare the clinical effects between Dynesys dynamic stabilization with microendoscopic discectomy (MED) and posterior lumbar interbody fusion (PLIF) treatment for the degenerative lumbar spinal stenosis in the elder, and to evaluate clinical advantages of Dynesys with MED according to enhanced recovery after surgery (ERAS).Methods:All of 79 cases (male 31, female 48) who suffered from the degenerative lumbar spinal stenosis were include mean age 67.32±5.88 years (from 60 to 81 years) during January 2012 to December 2017. Thirty-nine patients received Dynesys dynamic stabilization with MED (Dynesys group) and 40 cases undergone PLIF (fusion group). The operative time, blood loss, drainage, length of hospital stay, and complications were compared between the two groups. The visual analog scale (VAS), Oswestry disability index (ODI) were used to assess efficacy. The range of motion (ROM) of the lumbar spine and the adjacent segment by dynamic radiographs between two groups were reviewed to evaluate radiological results.Results:The fusion group was larger than Dynesys group in operation time (271.00±57.19 min vs. 193.85±32.17 min), blood loss (458.25±136.85 ml vs. 316.41±87.64 ml), drainage (143.12±47.46 ml vs. 101.67±31.23 ml) and length of hospital stay (15.70±3.01 d vs. 13.38±2.72 d) with statistics differences ( P<0.05). There was a significant difference in VAS and ODI between the two groups at the final follow-up, and Dynesys group was superior to the fusion group (VAS: 1.51±1.21 vs. 2.40±1.48, t=2.910, P=0.005; ODI: 11.90%±6.15% vs. 17.73%±6.85%, t=3.974, P<0.001). The lumbar ROM of Dynesys group increased comparing with the fusion group at post-operation one year (19.21°±6.08° vs. 14.08°±5.80°, t=0.425, P<0.001) and final follow-up (20.56°±6.37° vs. 16.33°±6.94°, t=2.828, P=0.006). ROM of the adjacent segment increased in fusion group at final follow-up (7.45°±2.45°) compared to pre-operation (4.68°±1.98°) and post-operation one year (4.83±1.43°) with significant difference ( F=24.437, P<0.001). The rate of epidural damage, delayed union, surface infection, internal fixation loose, thrombus, pulmonary infection, bedsore, reoperation of the fusion group were all higher than Dynesys group. Conclusion:The Dynesys with MED demonstrated better clinical and radiological results than fusion for degenerative lumbar spinal stenosis. As a method of safety and efficiency, the Dynesys and MED can speed up postoperative recovery of elderly patients in line with ERAS.

Objective:To investigate the expression of miR-527 in bladder cancer (BC) and its effect on the proliferation, migration and invasion of bladder cancer cells.Methods:From February 2018 to June 2019, the immortalized human bladder epithelial cell line SV-HUC-1 and human bladder cancer cell lines T24, UM-UC-3, 5637 and RT-112 were cultured in vitro. Real time quantitative PCR (qRT-PCR) was used to detect the expression of miR-527 in BC bladder cancer tissues and adjacent normal bladder tissues, human bladder cancer cell lines and human bladder epithelial immortalized cell lines. MiR-527 mimics, miR-527 inhibitor, ENO1 overexpression plasmid, ENO1 siRNA and corresponding negative control were transfected into bladder cancer cell line. CCK8 test, clone formation test and Transwell test were used to study the cell proliferation, migration and invasion. Luciferase reporter gene assay was used to verify the target gene of miR-527. Western blotting was used to analyze the regulation of miR-527 on target gene expression.Result:Compared with normal bladder tissue, the expression of miR-527 in bladder cancer was significantly lower (1.723±1.070 vs. 1.148±0.760, P<0.05). The relative expression of miR-527 in T24 (0.540±0.082), UM-UC-3 (0.230±0.053), 5637(0.463±0.085) and RT-112 (0.310±0.056) were significantly lower than those in SV-HUC-1 cells (0.987±0.111) with statistical significance ( P<0.05). Compared with the negative control (NC) group, CCK8 assay results showed that the cell viability was significantly decreased after transfection of miR-527 mimics into UM-UC-3 cells ( P<0.05). The clone formation test showed that the number of cell clones in UM-UC-3 cells transfected with miR-527 mimics was significantly lower than that in the control group (157.00±15.52 vs 57.33±15.50, P<0.05). Compared with the control group, the cell activity of T24 cells transfected with miR-527 inhibitor was significantly increased ( P<0.05). Compared with the control group, the number of cell clone formation was significantly increased (76.67±9.07 vs. 141.70±10.50, P<0.05). According to the prediction of targetscan database, ENO1 was the target gene of mir-527. Luciferase reporter gene experiment showed that the luciferase activity of mir-527 mimics group was significantly lower than that of control group (0.99±0.02 vs. 0.47±0.10, P<0.05), while the luciferase activity of miR-527 mimics group was significantly lower than that of control group (0.99 ± 0.02 vs. 0.47 ± 0.10, P<0.05), without statistical significance (1.03±0.04 vs. 0.96±0.05, P>0.05). Western blot analysis showed that the expression of ENO1 in miR-527 mimics group was significantly lower than that in NC mimics group (1.09±0.17 vs. 0.31±0.13, P<0.05), and the expression of ENO1 in miR-527 inhibitor group and NC inhibitor group were significantly increased (0.97±0.09 vs. 2.17±0.15, P<0.05). Compared with miR-527 mimics group, transfection of miR-527 mimics+ ENO1 overexpression plasmid could reduce the inhibitory effect of miR-527 mimics on proliferation, migration and invasion of bladder cancer cell line ( P<0.05). Compared with miR-527 inhibitor group, transfection of miR-527 inhibitor+ ENO1 siRNA could weaken the inhibit effect of miR-527 on the proliferation, migration and invasion of bladder cancer cell lines ( P<0.05). Conclusion:miR-527 is low expressed in BC and can be used as a tumor suppressor gene to inhibit the proliferation, migration and invasion of BC cells.

Craniopharyngioma is the most common benign intracranial tumor in children. The major post-operative complication is dysfunction of pituitary, which can result in many complicate clinical manifestations with hormonal deficiencies. Normochromic anemia has been reported as a common hematologic abnormality. However, pancytopenia is rarely reported so far. Here we describe a 21-year-old inpatient with the main complaint of nasal bleeding, who accepted craniopharyngioma surgery 9 years ago. Laboratory tests showed pancytopenia secondary to panhypopituitarism. This paper aims to increasing the awareness of this disease and accumulating clinical experiences for the clinicians.

OBJECTIVETo investigate the association between non-syndromic cleft lip with or without cleft palate (NSCL/P) and environmental factors in Ningxia population.

METHODSThis case-control study involved 453 NSCL/P patients and 452 normal newborns from Ningxia. A questionnaire focusing on various factors, including family history, pregnancy reaction, drug use during pregnancy, and infections, was used and responses were analyzed through Chi-square test and Logistic regression analysis with SPSS 16.0.

RESULTSThe constituent ratio of different types of NSCL/P was cleft lip∶cleft lip and palate∶cleft palate equal to 1︰2.02︰1.51. Logistic regression analysis revealed that abnormal pregnancy, infection, abortion, drugs, drinking, smoking, and living near factories likely increased the risk of NSCL/P (P<0.05). Single fetus, pregnancy-related nausea, vomiting, parents' moderate tastes, and eating soy foods and fruits decreased the risk of NSCL/P (P<0.05).

CONCLUSIONSThe incidence of NSCL/P should be reduced to enhance the conditions of women during pregnancy by maintaining a balanced diet and avoiding infections, abortion, drugs, and negative habits. 
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Case-Control Studies ; China ; epidemiology ; Cleft Lip ; epidemiology ; Cleft Palate ; epidemiology ; Diet ; Female ; Humans ; Incidence ; Infant, Newborn ; Parents ; Pregnancy ; Smoking

BACKGROUNDInsulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.

METHODSThis cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.

RESULTSTriglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.

CONCLUSIONTG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.

Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholesterol, HDL ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; Female ; Humans ; Insulin Resistance ; physiology ; Liver ; enzymology ; Male ; Middle Aged ; Triglycerides ; blood

Objective To study the clinical and pathological manifestations of microsporidian encephalitis.Methods The clinical findings and the brain pathological features of a patient with microsporidian encephalitis hospitalized in 2004 were studied.Results The onset was subacute or chronic. The body temperature was usually normal or below 37.5℃,but it rose when patient's condition deteriorated and coma appeaxed.The patient had hypoimmunity but without human immunodeficiency virus infection. Multifocal lesions in the whole brain,signs of meningeal irritation and infective myelogram were observed. Rheumatoid factor increased in the early stage and indirect bilirubin,proteins in cerebrospinal fluid(CSF), and immunoglobulin IgG,IgA increased in the middle stage.Cytological examination of CSF showed lymphocyte reaction.Blood routine test showed normal eosinophil granulocyte count.The patient was found to have pleurisy,peritonitis and cystitis.Brain magnetic resonance image(MRI)manifested plaque-like isometric T1 weight image and long T2 weight image signal in white matter of bilateral cerebral hemisphere and cerebella where FLAIR sequence showed hyperintensity.No apparent mass was identified.Contrast- enhanced MRI scan showed patchy and ring-like intensification.The neural system impairments were permanent and not improved after treatment.The pathology of brain tissue showed neuronal degeneration, karyopycnosis and Derivasculitis.The infectious agents were observed in the cytoplasm of neurons.Wister rats had muhiple organ inflammatory reaction 2 weeks after intraperitoneal inoculation of the patient's CSF and a large quantity of pathogens were found in the peritoneal lavage fluid.Conclusions The patient was PAS staining method is useful for detecting the pathogen in neurons and the rate can be raised by animal intraperitoneal cultivation