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.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

ObjectiveTo investigate the use of contraceptive methods， and to evaluate maternal healthcare services utilization among women within 2 years in Pudong New Area of Shanghai. MethodsA cross-sectional survey was conducted using a questionnaire for women at different postpartum periods who visited a community health clinic with their children from June to November 2021. Data were analyzed using χ² test and binary logistic regression. ResultsAmong the 1 946 postpartum women surveyed， 1 934 were either married or cohabiting， and1 430 had resumed their sexual life. Among women at 4， 6， 12， 18 and 24 months postpartum， the contraceptive prevalence rates （CPR） were 92.34% （193/209）， 92.16% （235/255）， 87.31% （282/323）， 91.95% （297/323） and 90.00% （288/320）， respectively. The modern contraceptive prevalence rates （mCPR） were 87.08% （182/209）， 87.06% （222/255）， 82.04% （265/323）， 83.09% （271/323） and 85.31% （273/320）， respectively， while the unmet contraceptive needs （UMNs） were 7.66% （16/209）， 7.84% （20/255）， 11.46% （37/323）， 6.81% （22/323） and 10.00% （32/320）， respectively. The use rates of long-acting reversible contraceptive （LARC） methods among women at 6， 12， 18 and 24 months postpartum period were 0.39% （1/255）， 2.17% （7/323）， 0.31% （1/323）， and 2.81% （9/320）， respectively. Among all surveyed subjects， 32.17% （626/1 946） had received postpartum contraceptive services only once， while 27.85% （542/1 946） had not received any postpartum contraceptive services. Binary logistic regression analysis indicated that the use of contraceptive methods among postpartum women was associated with whether relevant educational services were received after childbirth and during postpartum home visits （all P<0.05）. ConclusionPostpartum women have unmet needs for contraception. Contraceptive guidance at the 42-day postnatal healthcare visit needs to be further strengthened and postpartum contraceptive education could be integrated into the pregnancy care. The quality and effectiveness of contraceptive education during delivery and postpartum home visits， and even at the 42-day postnatal healthcare visit need to be further explored.

Objective:To investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.Methods:A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted. Among them, 64 were male and 358 were female. They range in age from 10 to 17. The MINI suicidal module assessment on the day of admission was employed. Based on the presence or absence of suicidal behavior in the past month, patients were divided into the attempted suicide group ( n=140) and the non-attempted suicide group ( n=302). Comparative analysis was performed on the sociodemographic characteristics, clinical features, endocrinological indices, and scores from the Eysenck Personality Questionnaire (EPQ), Short Form of the Family Environment Scale (FES-F), Adolescent Self-Rating Life Events Checklist (ASLEC), Childhood Trauma Questionnaire (CTQ), Multidimensional Anxiety Scale for Children (MASC), and Child Depression Inventory (CDI) between the two groups. Logistic regression was utilized to identify risk factors associated with suicidal behavior. Results:The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67% (140/442), and the lifetime prevalence was 53.8% (238/442). Compared to patients in the non-suicidal attempt group, those in the suicidal attempt group showed higher occurrences of psychotic symptoms, comorbid physical diseases, and past suicidal behaviors, respectively, at 46% (64/140) vs 26%(77/302), 34%(47/140) vs 21%(65/302), and 81% (114/140) vs 32%(98/302) (χ 2=18.00, 7.34, 91.94; all P<0.05). In terms of scale scores, patients in the suicidal attempt group, compared to those in the non-suicidal attempt group, had higher scores in the health adaptation factor in ASLEC, with[ M( Q1, Q3)] 6 (4, 9) vs 5(3, 8) (χ 2=2.13, P<0.05); higher scores in the somatic symptom factor in MASC, with 26 (19.25, 31) vs 24 (16, 29) (χ 2=2.50; P<0.05); and higher scores in the negative emotions, low self-esteem, interpersonal problems factors, and overall CDI score (χ 2=2.35; P<0.05). Regression analysis showed that psychotic symptoms ( OR=1.85, 95% CI: 1.13-3.02), comorbid physical illnesses ( OR=1.85, 95% CI: 1.09-3.14), and past suicidal behaviors ( OR=8.34, 95% CI: 5.01-13.88) were risk factors for recent suicidal behavior (all P<0.05). Conclusions:Among adolescent inpatients with depression, the past-month suicidal behavior and any suicidal behaviors in the past are pretty high. Previous suicidal behavior, presence of psychotic symptoms, and comorbid physical disease could be the risk factors for near-future suicidal behavior.

Objective:To investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.Methods:A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted. Among them, 64 were male and 358 were female. They range in age from 10 to 17. The MINI suicidal module assessment on the day of admission was employed. Based on the presence or absence of suicidal behavior in the past month, patients were divided into the attempted suicide group ( n=140) and the non-attempted suicide group ( n=302). Comparative analysis was performed on the sociodemographic characteristics, clinical features, endocrinological indices, and scores from the Eysenck Personality Questionnaire (EPQ), Short Form of the Family Environment Scale (FES-F), Adolescent Self-Rating Life Events Checklist (ASLEC), Childhood Trauma Questionnaire (CTQ), Multidimensional Anxiety Scale for Children (MASC), and Child Depression Inventory (CDI) between the two groups. Logistic regression was utilized to identify risk factors associated with suicidal behavior. Results:The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67% (140/442), and the lifetime prevalence was 53.8% (238/442). Compared to patients in the non-suicidal attempt group, those in the suicidal attempt group showed higher occurrences of psychotic symptoms, comorbid physical diseases, and past suicidal behaviors, respectively, at 46% (64/140) vs 26%(77/302), 34%(47/140) vs 21%(65/302), and 81% (114/140) vs 32%(98/302) (χ 2=18.00, 7.34, 91.94; all P<0.05). In terms of scale scores, patients in the suicidal attempt group, compared to those in the non-suicidal attempt group, had higher scores in the health adaptation factor in ASLEC, with[ M( Q1, Q3)] 6 (4, 9) vs 5(3, 8) (χ 2=2.13, P<0.05); higher scores in the somatic symptom factor in MASC, with 26 (19.25, 31) vs 24 (16, 29) (χ 2=2.50; P<0.05); and higher scores in the negative emotions, low self-esteem, interpersonal problems factors, and overall CDI score (χ 2=2.35; P<0.05). Regression analysis showed that psychotic symptoms ( OR=1.85, 95% CI: 1.13-3.02), comorbid physical illnesses ( OR=1.85, 95% CI: 1.09-3.14), and past suicidal behaviors ( OR=8.34, 95% CI: 5.01-13.88) were risk factors for recent suicidal behavior (all P<0.05). Conclusions:Among adolescent inpatients with depression, the past-month suicidal behavior and any suicidal behaviors in the past are pretty high. Previous suicidal behavior, presence of psychotic symptoms, and comorbid physical disease could be the risk factors for near-future suicidal behavior.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective:To evaluate Castor single-branch covered-stent in the treatment of Stanford B aortic dissection(TBAD)with insufficient anchorage zone.Methods:Clinical data of 25 TBAD patients (proximal healthy landing zone ≤15 mm) treated with Castor branched stent-graft at Weifang People's Hospital from Apr 2019 to Sep 2021 were analyzed retrospectively.The stent model was selected according to preoperative CTA examination and intraoperative angiography,the operation result and follow up data were reviewed.Results:The operation success rate was 100%,the mean operative time was (137.8±35.8)min, and the mean blood loss was (52.8±24.5)ml. There were 2 cases of internal leakage (IA) and it was disappeared after balloon dilation, Branched stent stenosis occurred in 2 cases and relieved by balloon dilatation. The mean follow-up time was 14.6 months, and the patency rate of branch stent was 100% during the follow-up period. The true lumen diameter of thoracic aorta was significantly expanded and the false lumen diameter was significantly reduced 3 months after surgery compared with that before surgery ( P<0.05). Conclusion:Castor stenting in the treatment of TBAD with insufficient proximal anchoring area is simple and feasible, with satisfactory short term clinical effect.

Objective:To study the genotype distribution of drug-related gene polymorphism of methotrexate (MTX) and leflunomide (LEF) in patients with rheumatoid arthritis (RA).Methods:The genotyping results of RA patients' MTX and LEF related genes(MTHFR677C/T, MTHFR1298A/C, ABCB13435T/C, DHODH19C/A and CYP1A2734C/A) detected in Shanghai Guanghua Hospital from December 2018 to May2019 and drug-related adverse effect were statisticallyanalyzed. The independence of allele distribution was tested by Hardy-Weinberg test. Counting data of genotypes and allele frequencies among the groups were analyzed by the chi-square test. Measurement data were showed as Mean±SD deviation. The network between incidence of adverse events and genotypes of patients was analyzed by cytoscape software. Results:Genotype distribution in 151 patients was consistent with Hardy-Weinberg genetic balance ( P>0.05), and genotype and allele distribution of each gene showed no statistical difference in gender ( P>0.05). The results showed that the most common genotype in RA were that genotypes of the good response with moderate resistance to MTX (MTHFR677CC/MTHFR1298AA/ABCB13435CT) (16 cases, 13.5%) and the good response with moderate side effect risk to LEF(DHODH19CC/CYP1A2734AC) (25 cases, 28.4%). According to the distribution frequency of alleles, the incidence of high side effects caused by MTX combined with LEF was predicted to be 2.9%, which was close to 1.8% of the actual genotypes of patients. The types and proportion of clinical adverse reactions in patients were retrospectively analyzed and the correlation network analysis was conducted with the genotype analysis results. It was found that the incidence rates of adverse reactions were liver injury (35.4%, 35/99), leukopenia (14.1%, 14/99), thrombocytopenia (2.0%, 2/99), and skin rash (1.0%, 1/99) from the top to the bottom. The top two genotypes that were related to the occurence of adverse events were MTHFR677CT/MTHFR1298AA/ABCB13435CT and DHODH19CA/CYP1A2734AC, respectively, which verified the consistency between drug-related genotype and clinical manifestations in RA patients. Conclusion:Our results suggested that genotype in RA patients is closely related to drug efficacy and adverse events. 2.9% of RA patients need to stop taking MTX and LEF due to high MTX resistance and poor MTX response and increased toxicity when combined with LEF, in which the proportion of liver injury is the highest.