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 investigate the association between obesity and insomnia among adults, so as to provide insights into obesity control and sleep health improvements among adult populations. Methods: Sixteen communities were randomly sampled from Longgang District, Shenzhen City using a multistage cluster sampling method, and permanent residents at ages of 18 years and older living in these communities were recruited as study subjects. Subjects' gender, age, educational level and marital status were collected using a self-designed questionnaire, and the body mass index ( BMI) was calculated. The sleep quality was evaluated using the Insomnia Severity Index ( ISI ), and the correlation between obesity and insomnia was evaluated using a multivariable logistic regression model. Results: A total of 10 434 questionnaires were allocated, and 9 425 valid questionnaires were recovered, with an effective recovery rate of 90.33%. The respondents included 3 448 men ( 36.58% ) and 5 977 women ( 63.42% ), and 6 940 respondents ( 73.63% ) were at ages of 18 to 44 years. There were 778 respondents with underweight ( 8.25% ), 5 522 with normal weight ( 58.59% ), 2 209 with overweight ( 23.44% ) and 916 with obesity ( 9.72% ). Among all respondents, 1 149 respondents were detected with insomnia, with a detection rate of 12.19%, including 839 subjects with mild insomnia ( 8.90% ), 247 subjects moderate insomnia ( 2.62% ) and 63 subjects with severe insomnia ( 0.67% ). Multivariable logistic regression analysis showed a statistically significant correlation between obesity and insomnia ( OR=2.179, 95%CI: 1.824-2.603 ). Conclusions There is a significant correlation between obesity and insomnia. Body weight management and sleep health education shall be intensified among adults.

Objective:To investigate the feasibility of dynamic contrast-enhanced (DCE)-MRI in assessing the depth of invasion (DOI) of early tongue squamous cell carcinoma.Methods:From January 2016 to December 2020, a total of 100 patients with early tongue squamous cell carcinoma confirmed by postoperative pathology were retrospectively analyzed in the Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. The study included 48 cases of T1 stage and 52 cases of T2 stage. All patients underwent routine MRI, DCE-MRI and contrast-enhanced T 1WI (CE-T 1WI) before surgery. The DOI was measured on images at different phases of axial DCE-MRI (30, 60 and 120 s after contrast injection) and CE-T 1WI (MRI-DOI) by 2 doctors independently. The intraclass correlation coefficient (ICC) was applied to evaluate the consistency of the measurements. MRI-DOI measured on DCE-MRI 30, 60, 120 s, CE-T 1WI and pathological DOI measured on biopsies were statistically analyzed with analysis of variance for repeated measurement and least significant difference t test. Pearson correlation coefficient was used to compare the correlation between MRI-DOI and pathological DOI. Receiver operation characteristic (ROC) curve analysis was used to explore the performance of MRI-DOI for clinical T1 and T2 staging. Results:There was a good consistency in MRI-DOI measured on DCE-MRI 30, 60, 120 s, and CE-T 1WI images with ICC of 0.752, 0.875, 0.883, and 0.841, respectively. The values of MRI-DOI were (8.35±3.52), (6.88±2.41), (7.52±2.65) and (8.60±3.39) mm, respectively, and pathological DOI was (5.75±2.01) mm. There was statistically significant difference in the overall comparison among different phases of MRI-DOI and pathological DOI ( F=69.25, P<0.001). MRI-DOI were significantly higher than pathological DOI ( P<0.05). All MRI-DOI measured on DCE-MRI 30, 60, 120 s and CE-T 1WI correlated positively with pathological DOI ( r=0.574, 0.851, 0.731, 0.663, all P<0.001). MRI-DOI derived from DCE-MRI 60 s showed the highest diagnostic efficiency for T1 and T2 staging (area under the ROC curve was 0.931, 95%CI 0.881-0.982). When the optimal cutoff value was 6.0 mm, the accuracy, sensitivity and specificity were 88.0%, 96.2% and 79.2%, respectively. Conclusions:DCE-MRI can be applied to assess DOI in early tongue squamous cell carcinoma. MRI-DOI based on DCE-MRI 60 s has the best correlation with pathological DOI and has a potential to predict clinical T staging in early tongue squamous cell carcinoma.

Objective To establish an online quantitative analysis model for moisture content assay of hydroxychloroquine sulfate particles by near infrared (NIR) spectroscopy. Methods The NIR spectra were collected in real time when the material particles were dried in the fluidized bed. Meanwhile the water content of the particles was measured with the standard moisture tester. The multiplicative signal correction (MSC) and first derivative followed by Karl Norris smoothing were used for spectra pretreatment. Two spectral range (4 935−5 336 cm⁻¹ and 6 911−7 297 cm⁻¹) were selected for the quantitative model with the partial least squares (PLS) regression. Results The quantitative calibration model had good correlation coefficients with Rc value=0.952 9 and Rp value=0.936 6. The root mean square error of calibration (RMSEC) was 0.408 and the root mean square error of prediction error (RMSEP) was 0.435. The ratio of standard deviation of validation set to prediction standard deviation (RPD) was 5.18. There was no significant difference between the predicted value and the reference value by t test when the established model was applied in large-scale production. Conclusion The online model established for monitoring water content has high accuracy and stability, which can be applied in industrial scale process to monitor the particle moisture in real time.

OBJECTIVE：To reference for the rational use of sodium va lproate in clinic. METHODS ：By retrospective analysis，blood concentration monitoring results of sodium valproate and medical record data in 856 patients were collected from the Affiliated Tianyou Hospital of Wuhan University of Science and Technology during Jan. 2016-Dec. 2018. The dosage form of sodium valproate ，monitoring times of therapeutic drugs ，monitoring results of steady-state blood concentration of sodium valproate up to the standard ，dosage adjustment and the combination with carbamazepin ，fluconazol and carbapenem drugs were analyzed. Fisher exact test was used to analyze the factors influencing the steady-state blood concentration of sodium valproate up to the standard. RESULTS ：A total of 1 270 cases of sodium valproate were monitored in 856 patients，involving 407 males and 449 females，with age of （38.2±13.8）years and body mass of （52.3±10.0）kg. Among 1 270 cases of monitoring ，steady-state blood concentration of sodium valproate in 554 cases were in the range of 50-100 µg/mL，and 43.6％ of which reached the standard. The rate of reaching the standard in patients with multiple monitoring was higher than patients with single monitoring ；the dosage of patients with last monitoring reaching the standard was higher than that of patients with the first monitoring reaching the standard. The rate of reaching the standard in Sodium valproate sustained-release tablet group was higher than general Sodium valproate tablet group；the carbamazepin/fluconazol free group was higher than the carbamazepin combination group and fluconazol combination group；the carbapenem free group was higher than the carbapenem combination group （all P＜0.05）. CONCLUSIONS ：Clinical pharmacists should pay attention to the monitoring of sodium valproate treatment drugs ， strengthen the publicity and 3551851542@qq.com education of patients and their families ，and try to use Sodium valproate sustained-release tablets. When patients additionally receive carbapenem drugs like carbamazepin or fluconazol ， the standard level of sodium valproate will be reduced ，then the dosage of sodium valproate should be adjusted.

OBJECTIVE To provide prenatal diagnosis for families affected with tuberous sclerosis complex and explore the correlation between phenotype and genotype. METHODS For probands from 10 families, all exons and splicing regions of the TSC1 and TSC2 genes were analyzed with high throughput DNA sequencing. Suspected mutations were verified by Sanger sequencing. RESULTS All probands were found to have mutations, which included 1 case with TSC1 mutation and 9 cases with TSC2 mutations (missense mutations in 6, nonsense mutations in 2, and frameshifting mutation in 1 case). Prenatal diagnosis was provided for 9 cases, and 1 fetus was found to carry a mutation. Genetic analysis has identified a novel pathogenic mutation (TSC2 c.2415-2416 ins GT). CONCLUSION Identification of pathological mutations for tuberous sclerosis complex can facilitate genetic counseling and prenatal diagnosis for the affected families.

OBJECTIVETo provide prenatal diagnosis for two couples who respectively carried heterozygous CD41-42 (-TCTT) and CD43 (G>T) mutations of the beta hemoglobin gene.

METHODSThe mutations were simultaneously detected with reverse dot blot (two diagnostic kits), multi-color melting curve analysis and sequencing analysis.

RESULTSThe fetus of family 1 was shown to be heterozygous for CD43 (G>T) by the three methods, while the fetus of family 2 was shown to be double heterozygous for CD41-42 (-TCTT) and CD43 (G>T) by multi-color melting curve analysis and sequencing analysis. The two diagnostic kits yielded different results by reverse dot blot, one as double heterozygous for CD41-42 (-TCTT) and CD43 (G>T), and another as homozygous for CD41-42 (-TCTT).

CONCLUSIONFor prenatal diagnosis of couples carrying mutations of beta hemoglobin gene such as CD41-42 (-TCTT) and CD43 (G>T), other methods such as Sanger sequencing should be used in order to avoid misdiagnosis.

Diagnostic Errors ; Female ; Heterozygote ; Humans ; Male ; Mutation ; Pregnancy ; Prenatal Diagnosis ; Reagent Kits, Diagnostic ; beta-Globins ; genetics ; beta-Thalassemia ; diagnosis ; genetics

Objective This study aimed to investigate the associations between adipose tissue distribution and risks of macro-vascular complications in type 2 diabetic patients. Methods The study included T2DM patients either previously diagnosed by questionnaire or newly diagnosed with fasting plasma glucose(FPG)≥7. 0 mmol/L and/or 2 hour postprandial glucose ( 2h PG )≥11. 1 mmol/L from residents older than 40 years from Jiading Community, Shanghai, China(n=10 375). Each participant had gone through anthropometric measurements, blood tests, vascular function tests including carotid intima-media thickness ( CIMT ) , ankle-brachial index ( ABI ) , branchial-ankle pulse wave velocity( baPWV) as well as carotid plaques. Results WHR quartiles was significantly associated with high risks for ten-year cardiovascular disease risks [ ASCVD high risk: OR:1. 17 ( 1. 05-1. 31 );Framingham high risk:1. 13(1. 00-1. 29)]. However, WHR has no significant relations with risks of increased carotid intima-media thickness( CIMT) , abnormal ankle-brachial index( ABI) , increased brachial ankle pulse wave velocity( baPWV) or carotid plaques. Conclusions In type 2 diabetic patients, abdominal adipose tissue has an independent role in high risk for ten-year cardiovascular diseases. However it has no relations with other vascular functions including increased CIMT, abnormal ABI, increased baPWV, or carotid plaque.

[Summary] A 47 years old female presented with palpitation, tremble, sweaty, and weight gain. Insulinoma was suspended and confirmed with hypoglycemia caused by endogenous hyperinsulinemia. The CT scan was failed to localize the tumor. MRI and ASVS showed inconsistent results. A nutrient arterial was found by arterial angiography and explained the different results. Robert assistant surgery successfully removed the tumor and the patient was well recovered.