To analyze global trends and research hotspots in exercise intervention for overweight and obesity from 2010 to 2024, to provide novel perspectives for comprehensive management research on overweight and obesity.

ObjectiveTo construct and evaluate a mouse model that simulates the pathological progression of immune checkpoint inhibitor-associated pneumonitis (CIP), in order to address the critical issue of the lack of standardized animal models in this research field. MethodsThirty-five SPF-grade 6-week-old male C57BL/6J mice were randomly assigned to a control group (n=5), a bleomycin (BLM) group (n=15), and a BLM+programmed death-1 (PD-1) monoclonal antibody (BLM+PD-1) group (n=15). Corresponding drugs were administered via intraperitoneal injection for intervention. The general condition, body weight changes, survival rate, and pulmonary histopathological alterations were systematically monitored. ResultsCompared with the BLM group, the BLM+PD-1 group exhibited significantly more severe pulmonary fibrosis, characterized by progressive body weight loss and more severe deterioration of general conditions. Histopathological examination showed that pulmonary inflammation was alleviated 4 weeks post-modeling in the BLM group. In contrast, pulmonary lesions continued to worsen in the BLM+PD-1 group, with no evidence of resolution of inflammation 28 days post-modeling. Quantitative immunohistochemical analysis revealed that the positive expression rate of interleukin-17A (IL-17A) in lung tissues reached 34.28% in the BLM+PD-1 group 14 days post-modeling, which was markedly higher than that in the BLM group (24.02%, P < 0.000 1). The positive expression rate of α-smooth muscle actin (α-SMA) was 12.40% in the BLM+PD-1 group 14 days post-modeling, nearly twice the level in the BLM group (5.87%). 28 days post-modeling, the positive expression rate of α-SMA remained at 7.72% in the BLM+PD-1 group, while it declined to 3.38% in the BLM group. ConclusionThe addition of a PD-1 inhibitor to bleomycin treatment accelerates the progression of pulmonary interstitial fibrosis and effectively recapitulates the pathological process of lung injury and fibrosis driven by aberrant immune activation during clinical immunotherapy. Accordingly, this study successfully establishes a dynamic CIP animal model recapitulating the progression from early inflammatory response to pulmonary fibrosis. This model addresses the critical shortage of animal models for this condition and offers an experimental platform for further mechanistic studies and the development of therapeutic strategies.

To investigate the bone health status and potential influencing factors of bone mineral density in adult patients with hemophilia, providing a reference for improving their bone health and for the prevention, treatment, and rehabilitation intervention of osteoporosis.

Objective:To explore the chain mediating effect of social support and coping style between stigma and self-management behavior in diabetic foot patients.Methods:A total of 224 patients with diabetic foot who visited the Outpatient Department of Xinxiang Central Hospital were selected as participants by convenience sampling. Type 2 Diabetes Stigma Assessment Scale, Social Support Rating Scale, Medical Coping Modes Questionnaire and Diabetes Foot Self-Care Behavior Scale were used for survey. Model 6 in the SPSS PROCESS program was used to test for chain mediating effects.Results:Univariate analysis showed that there were statistically significant differences in self-management behavior scores among patients of different ages, educational levels, work status, average monthly family income, Wagner grading, and whether they received foot health education ( P<0.05). Correlation analysis showed that there was a significant correlation between stigma, social support, coping style, and self-management behavior, with statistical differences ( P<0.05). Mediating effect analysis showed that, in addition to the direct effect of stigma on the self-management behavior of diabetic foot patients, it also had an impact on self-management behavior through the separate mediating effect of social support and coping style (facing and resignation) and the chain mediating role of the two. Conclusions:Stigma can not only directly affect the self-management behavior of diabetic foot patients, but also indirectly affect them through the mediating role of social support and coping style (facing and resignation). The self-management of patients with diabetic foot can be improved by reducing their stigma, increasing social support and encouraging patients to be brave in coping with the disease.

Objective To compare the short-term clinical effects of unilateral dual-channel endoscopic discectomy(UBED)and percutaneous endoscopic intervertebral discectomy(PEID)in the treatment of L5S,Lumbar disc herniation,LDH.Methods From January 2019 to January 2021,a total of 57 cases of L5S,LDH treated by UBED or PEID were analyzed retrospectively,including 30 cases in UBED group and 27 cases in PEID group.The operation time,intraoperative fluoroscopy times,postoperative hospitalization days and surgical complications were compared between the two groups.The visual analogue scale(VAS)and oswestry disability index(ODI)were used to compare the postoperative quality of life of the two groups,and the modified MacNab criteria was used to evaluate the clinical efficacy in the last follow-up.Results The operation time of UBED group and PEID group was(75.30±8.44)minutes and(68.37±4.63)minutes,respectively,and the difference between the two groups was statistically significant(P＜0.05).VAS and ODI of 1 week,3 months,1 year and 1.5 years after surgery in 2 groups were significantly decreased compared with those before surgery,with statistical significance(P＜0.05).The VAS score of low back pain in UBED group was higher than that in PEID group[(3.87±1.14)points vs(2.70±0.67)points]at 1 week after surgery(P＜0.05),and there was no significant difference in VAS and ODI at the other time points(P＞0.05).There was no statistical difference in the results of modified MacNab criteria in the last follow-up(P＞0.05).There were 2 cases of dural tear in PEID group,1 case of dural tear in UBED group and 1 case of temporary nerve root injury in PEID group after operation,all of which were cured after symptomatic treatment.Conclusion Compared with PEID,UBED has a longer operation time,more trauma and more obvious low back pain in the short term after operation.The short-term curative effect of the two operations on L5S1 LDH is similar,the incidence of complications is low,and the times of fluoroscopy are few.Both operations are safe and effective.

Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective:To explore the level of physical activity of Chinese adults with haemophilia and its related factors so as to provide a reference for their comprehensive management.Methods:The daily physical activity of adults with haemophilia was surveyed using the International Physical Activity Questionnaire (IPAQ). A total of 110 questionnaires were eligible for analysis at last. The results were compared with published data from other societies using independent sample t-tests and chi squared tests. Spearman correlation analysis and multivariate logistic regression analysis were applied to explore factors related to the subjects′ physical activity levels.Results:Fully 30.9% of the subjects claimed to maintain a high level of physical activity. This was significantly different from the distribution of physical activity observed in Japan (12.4%), Ireland (50.9%) and the United Kingdom (43.1%). According to the Spearman correlation analysis, the number of joints affected, anxiety, and depression are all significantly related to the level of physical activity among such adults. Multivariate logistic regression analysis showed that depression was an independent factor affecting the patients′ level of physical activities.Conclusion:Chinese and Japanese adults with hemophilia have relatively low levels of physical activity, possibly influenced by depression.

Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective:To determine the minimum clinically-important difference (MCID) in the rehabilitation effect among children with haemophilic knee joint contracture.Methods:The data describing 28 children with an average age of 13.89±3.00 years and haemophilic knee joint contracture who received no less than 10 sessions of physiotherapy in the Department of Rehabilitation Medicine at the Peking Union Medical College Hospital were analyzed. The therapeutic effect of the treatement was quantified in terms of Haemophilia Joint Health Scores (HJHSs) for their knees. The MCID after the therapy was evaluated using the mean change method, multivariate linear regression, receiver operating characteristics, and the distribution-based method.Results:The MCID for the improvement of knee HJHS was 5.13 by the mean change method, 4.31 by multivariate linear regression, 3.50 according to the ROC curve and 1.64 by the distribution-based method. Taking all of them into consideration, 4.31 was found to be an appropriate value.Conclusions:The MCID after physical therapy for the improvement in knee HJHS for a child with haemophilic knee contracture is 4.31. Improvements greater than 4.31 can be considered clinically significant.

Objective: To improve the understanding of rare anti-myelin-associated glycoprotein (MAG) positive IgM monoclonal gammopathy related peripheral neuropathy (IgM-PN) . Methods: Eleven cases of IgM paraproteinemia and anti-MAG antibody positive neuropathy diagnosed since 2014 in Peking Medical Union College Hospital were summarized. The medical records including clinical manifestation, lab results, treatment and prognosis were analyzed. Results: Among the 11 patients (8 male and 3 female) , the median onset age is 63 years old (range from 52 to 77 years old) . The peripheral neuropathy of 9 patients were characterized by distal onset of numbness, 6 patients suffered from muscle weakness. The nerve conduction velocity study indicated that all 11 patients had demyelinating peripheral nerve damage, which was sensory predominant and more severe in lower limbs, 6 of them had secondary axonal damage. Monoclonal IgM gammopathy was identified in all 11 patients, among which 6 were IgM κ, 2 IgG κ and IgM κ bi-clonal, 3 IgM λ. Three patients were diagnosed with Waldenström’s macroglobulinaemia. The anti-MAG-IgM antibody was positive in all 11 cases. After diagnosis, 9 patients received combination chemotherapy including rituximab or rituximab treatment alone. The monoclonal IgM level declined significantly in 7 patients. The neuropathy was stable or improved. Conclusions Anti-MAG antibody positive IgM-PN is a rare M protein related disease. In peripheral neuropathy with undetermined etiology, we suggest to screen M protein and anti-MAG antibody. Chemotherapy including rituximab or rituximab alone is recommended as first-line therapy.