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.

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 evaluate the effectiveness of a hospital logistics operation and management based on the"one center,four platforms"model.Methods In line with the grading evaluation standards for hospital intelligent management,we used technologies such as big data,Internet of Things,Internet Plus,and artificial intelligence to develop a"one center,four platforms"model.This model consisted of a logistics intelligent operation and maintenance management center,an equipment control information platform,a security prevention information platform,an energy consumption monitoring information platform,and an operation management information platform.Results The equipment fault resolution capability,enhanced by the"smart linkage",showed a significant improvement.In 2022,false alarms decreased by 28.63%compared to 2021,with high-level and ordinary-level alarms decreasing by 69.53%and 33.15%,respectively.The"one-stop"logistics service capability was signifi-cantly improved,as indicated by a 2.92%decrease in maintenance frequency in 2022 compared to 2021.This improvement was further reflected in the quality of maintenance and a decrease in the repeated maintenance occurrences.The energy consumption control capability,based on the"data mining",showed a significant improvement,with an 8.71%year-on-year decrease in en-ergy expenditure of ten thousand yuan in 2022 compared to 2021.Conclusion The"one center,four platforms"model can sig-nificantly enhance the efficiency of logistics operation and maintenance management.

AIM: To analyze the correlations among parameters from iTrace visual function analyzer, Pentacam 3D anterior segment analysis system and lens opacities classification system(LOCS)Ⅲ in the assessment of lens opacity of age-related cataract(ARC)patients.METHODS: A prospective cross-sectional study. A total of 104 ARC patients(104 eyes)in the department of ophthalmology of our hospital from May to August, 2021 were included. The cataracts of patients were graded based on LOCSⅢ using a slit-lamp. Opacity map grade(OMG)and dysfunctional lens index(DLI)were obtained by iTrace. Pentacam nucleus staging(PNS)and Scheimpflug images of lenses were acquired by Pentacam. The regional integrated density(IntDen)of Scheimpflug images was obtained by ImageJ. The normality and correlations of parameters were analyzed by SPSS 26.0.RESULTS: All the parameters were normally distributed except 3mm IntDen and IntDen of 6mm posterior subcapsular region. PNS positively correlated with nuclear color(NC)and nuclear opalescence(NO)(r=0.521, 0.440, all P<0.01). The 3mm IntDen positively correlated with NC and NO(rs=0.459, 0.450, all P<0.01). IntDen of 3mm nucleus region positively correlated with NC and NO(r=0.539, 0.543, all P<0.01). IntDen of 3mm posterior subcapsular region was negatively correlated with NC and NO(r=-0.315, -0.321, all P<0.01). 6mm IntDen positively correlated with NC and NO(r=0.321, 0.288, all P<0.01). 3mm DLI negatively correlated with NC, NO, and posterior subcapsular cataract(PSC)(r=-0.257, -0.234, -0.282, all P<0.01). 6mm DLI negatively correlated with NC, NO, PSC(r=-0.247, -0.304, -0.227, all P<0.05). 3mm OMG positively correlated with CC and PSC(r=0.268, 0.333, all P<0.01), and 6mm OMG positively correlated with CC and PSC(r=0.275, 0.245, all P<0.05). 3mm DLI negatively correlated with PNS and IntDen of 3mm nucleus region(r=-0.217, -0.197, all P<0.05).CONCLUSION:Each lens opacity assessment system had its own advantages. Taking all parameters into comprehensive consideration is conducive to objectively eraluate the opacity degree of each area of the lens and provide references for clinical work.

ObjectiveTo investigate the expression of tRNA-derived fragments （tRFs） 3'tiR_026_GlnCTG （n） in PTC and its carcinogenic mechanism. MethodsFirst， two pairs of PTC and adjacent normal thyroid tissues were used for high-throughput microarray to screen differential tRFs. Based on the microarray results， we verified the expression of significantly different tRFs in 10 pairs of PTC and adjacent normal thyroid tissues. Then， we increased sample sizes and verified the expression of 3'tiR_026_GlnCTG （n） in another 46 pairs of PTC and adjacent normal thyroid tissues by Quantitative PCR （qPCR）. Mimics of3'tiR_026_GlnCTG （n） were transfected into PTC cell lines. The expression level was verified by quantitative reverse transcription polymerase chain reaction （qRT-PCR） and the transfection was confirmed. Meanwhile， the transfected cell lines were lysed， protein was extracted， incubated with relevant antibodies including the MEK/ERK/p90RSK signaling pathway and the western blotting was performed. Results3'tiR_026_GlnCTG （n） is one of the most significantly upregulated tRFs between PTC tissues and adjacent normal tissues. Overexpression of 3'tiR_026_GlnCTG （n） promoted migration， invasion and proliferation in KTC1 and BCPAP cells. MEK/ERK pathway inhibitors decrease the migration， invasion and proliferation in KTC1 and BCPAP cells. The phosphorylation of MEK， ERK and their downstream target p90RSK was significantly increased in 3'tiR_026_GlnCTG （n）-overexpressing cells. Conclusions3'tiR_026_GlnCTG （n） might play a key oncogenic role in PTC tumorigenesis and development by activating the MEK/ERK/p90RSK pathway. It will provide new insight into the pathogenesis of PTC and may lead to effective therapeutic strategies.

Objective:Petersen hernia is a rare but severe complication after gastrectomy, which has been reported by very few studies. This study is dedicated to summarize the clinical characteristics and management of Petersen hernia after gastrectomy in patients with gastric cancer in order to provide reference to clinical practice.Methods:A descriptive case-control study was carried out. All the qualified patients were screened from the database of digestive malignancies in Nanjing Drum Tower Hospital. The inclusion criteria were as follows: Petersen hernia confirmed during operation; previous gastrectomy history due to gastric cancer; complete clinical data. The clinical manifestation, perioperative data and follow-up outcome were summarized.Results:A total of 12 qualified patients were included. They were all male with a mean age of (65.3±8.5) years old, and whose clinical presentation had last for (6~143) hours (median: 21 hours). Common complaints included abdominal pain and bloating. All the patients were admitted to the emergency department. Preoperative CT showed dilatation and effusion of small intestine. Other imaging manifestations included whirlpool sign, target sign, mesenteric retraction or congestion and edema, abdominal and pelvic effusion, etc. Hematological examination showed white blood cell count, ratio of neutrophils, procalcitonin and C-reactive protein were higher than the normal range. The median interval to previous gastrectomy is 20.5 (0.5-55.0) months. The previous gastrectomy of 12 cases included 2 cases of laparoscopic surgery and 10 of laparotomies. Ten cases underwent emergency surgery immediately, and 2 cases underwent surgery after ineffective conservative treatment. Six cases received small bowel restoration without bowel resection, and the other 6 cases received small bowel resection with a mean length of 76 (11~300) cm. Six cases were transferred into ICU with a stay of (2.5±0.8) days. One case deceased at postoperative day 2, due to subtotal small bowel resection, and the other 11 cases survived without grade III or above complication according to Clavien-Dindo classification. The overall postoperative hospitalization was (9.2±3.6) days. During the postoperative follow-up, no acute gastrointestinal symptoms or acute abdomen recurred.Conclusions:Petersen hernia is more common in male, whose onset and progress are rapid and emergent, and prognosis is poor.

Objective:Petersen hernia is a rare but severe complication after gastrectomy, which has been reported by very few studies. This study is dedicated to summarize the clinical characteristics and management of Petersen hernia after gastrectomy in patients with gastric cancer in order to provide reference to clinical practice.Methods:A descriptive case-control study was carried out. All the qualified patients were screened from the database of digestive malignancies in Nanjing Drum Tower Hospital. The inclusion criteria were as follows: Petersen hernia confirmed during operation; previous gastrectomy history due to gastric cancer; complete clinical data. The clinical manifestation, perioperative data and follow-up outcome were summarized.Results:A total of 12 qualified patients were included. They were all male with a mean age of (65.3±8.5) years old, and whose clinical presentation had last for (6~143) hours (median: 21 hours). Common complaints included abdominal pain and bloating. All the patients were admitted to the emergency department. Preoperative CT showed dilatation and effusion of small intestine. Other imaging manifestations included whirlpool sign, target sign, mesenteric retraction or congestion and edema, abdominal and pelvic effusion, etc. Hematological examination showed white blood cell count, ratio of neutrophils, procalcitonin and C-reactive protein were higher than the normal range. The median interval to previous gastrectomy is 20.5 (0.5-55.0) months. The previous gastrectomy of 12 cases included 2 cases of laparoscopic surgery and 10 of laparotomies. Ten cases underwent emergency surgery immediately, and 2 cases underwent surgery after ineffective conservative treatment. Six cases received small bowel restoration without bowel resection, and the other 6 cases received small bowel resection with a mean length of 76 (11~300) cm. Six cases were transferred into ICU with a stay of (2.5±0.8) days. One case deceased at postoperative day 2, due to subtotal small bowel resection, and the other 11 cases survived without grade III or above complication according to Clavien-Dindo classification. The overall postoperative hospitalization was (9.2±3.6) days. During the postoperative follow-up, no acute gastrointestinal symptoms or acute abdomen recurred.Conclusions:Petersen hernia is more common in male, whose onset and progress are rapid and emergent, and prognosis is poor.

Diabetes mellitus complicated with cerebral infarction is the commonest and most serious vascular complication of diabetes mellitus. With a high disability and mortality rate, it seriously threatens human health. Because the pathogenesis is still unclear, more and more scholars have focused on the research of diabetic cerebral infarction at home and abroad. Traditional Chinese medicine(TCM) compounds have a remarkable curative effect in the treatment of diabetic cerebral infarction. Its mechanisms of action mainly include anti-hypertension, reduction of blood sugar and lipid, promotion of vascular regeneration and vascular endothelial function, anticoagulation, anti-thrombosis, improvement of nerve function defect, reduction of infarct volume, improvement of hemorheological, inhibition of inflammation and platelet aggregation, and promotion of collateral circulation. Through literature search, this paper summarizes the research progress of the mechanisms of TCM compounds in treating diabetic cerebral infarction in recent five years at home and abroad, in order to provide reference for clinical treatment.

OBJECTIVEAnesthetic isoflurane plus surgery has been reported to induce cognitive impairment. The underlying mechanism and targeted intervention remain largely to be determined. Ginsenoside Rb1 was reported to be neuroprotective. We therefore set out to determine whether ginsenoside Rb1 can attenuate isoflurane/surgery-induced cognitive dysfunction via inhibiting neuroinflammation and oxidative stress.

METHODSFive-months-old C57BL/6J female mice were treated with 1.4% isoflurane plus abdominal surgery for two hours. Sixty mg/kg ginsenoside Rb1 were given intraperitoneally from 7 days before surgery. Cognition of the mice were assessed by Barnes Maze. Levels of postsynaptic density-95 and synaptophysin in mice hippocampus were measured by Western blot. Levels of reactive oxygen species, tumor necrosis factor-α and interleukin-6 in mice hippocampus were measured by ELISA.

RESULTSHere we show for the first time that the ginsenoside Rb1 treatment attenuated the isoflurane/surgery-induced cognitive impairment. Moreover, ginsenoside Rb1 attenuated the isoflurane/surgery-induced synapse dysfunction. Finally, ginsenoside Rb1 mitigated the isoflurane/surgery-induced elevation levels of reactive oxygen species, tumor necrosis factor-α and interleukin-6 in the mice hippocampus.

CONCLUSIONThese results suggest that ginsenoside Rb1 may attenuate the isoflurane/surgery-induced cognitive impairment by inhibiting neuroinflammation and oxidative stress pending future studies.

Anesthetics, Inhalation ; adverse effects ; Animals ; Cognition ; Cognitive Dysfunction ; etiology ; prevention & control ; Female ; Ginsenosides ; pharmacology ; Hippocampus ; drug effects ; Inflammation ; etiology ; prevention & control ; Isoflurane ; adverse effects ; Medicine, Chinese Traditional ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; Postoperative Complications ; etiology ; prevention & control ; Random Allocation ; Surgical Procedures, Operative ; adverse effects ; Synapses ; metabolism

Objective To systematically assess the relationship between oral administration of aspirin and survival benefit for patients with colorec?tal cancer(CRC)by meta?analysis. Methods Relevant studies were identified through searching PubMed and EMBASE. Random?effects model was derived to composite the pooled hazard ratio for overall mortality and CRC?specific mortality. The subgroup analysis was conducted for included data,and the bias analysis was reported. Results Thirteen studies on aspirin therapy were finally included in this meta?analysis. The overall surviv?al benefit associated with oral administration of aspirin represented an HR of 0.83(95%CI:0.71?0.96). Oral administration of aspirin was also asso?ciated with CRC?specific survival(HR=0.77,95%CI:0.64?0.93). No evidence was observed of an association between prediagnostic aspirin use and CRC overall survival(HR=1.00,95%CI:0.85?1.18)or CRC?specific survival(HR=0.97,95%CI:0.83?1.13). Conclusion These findings provide further indication that post?diagnostic aspirin therapy can improve CRC prognosis.