Objective: To investigate the prevalence levels and trends of overweight and obesity among adult residents in Zhejiang Province from 2015 to 2023, so as to provide a basis for developing regional weight management strategies. Methods: Permanent residents aged ≥18 years from Zhejiang Province who participated in the China Chronic Disease and Risk Factor Surveillance Project in 2015, 2018, and 2023 were selected as survey subjects. Data on sociodemographic information, height, weight and waist circumference were collected through questionnaire surveys and physical examinations. The prevalence of overweight, obesity, and central obesity were calculated and standardized using data from the Seventh National Population Census of Zhejiang Province in 2020. The Cochran-Armitage trend test was employed to analyze the trends in prevalence of overweight, obesity, and central obesity across different genders, ages and regions. Results: A total of 23 902 individuals were surveyed, comprising 10 985 males (45.96%) and 12 917 females (54.04%). Participants were aged ≥60 years, with 13 088 individuals accounting for 54.76%. There were 9 388 urban residents (39.28%) and 14 514 rural residents (60.72%). The standardized prevalence of overweight among residents increased from 30.05% in 2015 to 33.98% in 2023, the standardized prevalence of obesity increased from 7.67% to 15.22%, and the standardized prevalence of central obesity increased from 22.81% to 33.82%, all showed upward trends (all P<0.05). In 2015, 2018, and 2023, the standardized prevalence of overweight was higher in males than in females. In 2018 and 2023, the standardized prevalence of obesity and central obesity were higher in males than in females (all P<0.05). From 2015 to 2023, the standardized prevalence of overweight, obesity, and central obesity among both males and females showed upward trends (all P<0.05). In 2015, 2018 and 2023, the prevalence of central obesity showed an increasing trend with age (all P<0.05). From 2015 to 2023, upward trends were observed in the prevalence of overweight, obesity, and central obesity among residents aged 18-<45 years and aged ≥60 years, as well as in the prevalence of obesity and central obesity among residents aged 45-<60 years (all P<0.05). In 2015, 2018 and 2023, the standardized prevalence of overweight obesity were higher in urban areas than in rural areas, while the standardized prevalence of central obesity was lower in urban areas (all P<0.05). From 2015 to 2023, the standardized prevalence of overweight, obesity, and central obesity among both urban and rural areas showed upward trends (all P<0.05). Conclusion From 2015 to 2023, the prevalence of overweight, obesity, and central obesity among adult residents in Zhejiang Province showed increasing trends, with variations in prevalence levels and trends observed across genders, ages, and urban / rural areas.

Objective:To analyze the clinical characteristics of mannose phosphate isomerase-congenital disorders of glycosylation (MPI-CDG) and evaluated the outcomes following D-mannose treatment.Methods:This case-series study analyzed clinical manifestations, laboratory findings, imaging results, genetic data, and outcomes after D-mannose therapy in 5 children with MPI-CDG diagnosed at the Children′s Hospital of Fudan University between December 2014 and December 2024.Results:The age of onset ranged from 0.3 to 0.4 years in all 5 children, who initially presented with diarrhea and hypoglycemia. Associated manifestations included short stature (3 cases), anemia (3 cases), splenomegaly (3 cases), hepatomegaly (4 cases), elevated transaminases (4 cases), and hypoalbuminemia (4 cases). Liver pathology revealed hepatic fibrosis in 3 cases. Genetic testing identified 8 variants in the MPI gene, including 2 novel variants. Following D-mannose treatment, diarrhea and hypoglycemia resolved within 1-2 weeks in all children, with concurrent improvement in anemia. Notably except for Patient 1, who developed progressive splenomegaly, worsening hepatic fibrosis, and portal hypertension despite persistently normal transaminase and albumin levels, the other 4 children showed improvement in transaminase levels, resolution of hypoalbuminemia and amelioration of imaging abnormalities.Conclusions:MPI-CDG typically manifests in infancy with diarrhea and hypoglycemia, often accompanied by multi-system involvement. D-mannose treatment significantly improves metabolic abnormalities and most organ damages. However, close surveillance of liver status is warranted due to the risk of hepatic fibrosis progression in some cases.

Objective To investigate the diagnostic value of transforming growth factor-β1(TGF-β1),cal-granulin A8(S100-A8)and interleukin-17(IL-17)in spinal tuberculosis and their relationship with erythro-cyte sedimentation rate(ESR)and C-reactive protein(CRP).Methods A total of 103 patients diagnosed with spinal tuberculosis in the Second Hospital of Lanzhou University from July 2017 to December 2023 were se-lected as the study group,and 109 healthy people were selected as the control group during the same period.The general data of the two groups were collected,and the levels of TGF-β1,S100-A8,IL-17,ESR and CRP were compared between the two groups.The receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic value of TGF-β1,S100-A8 and IL-17 for spinal tuberculosis.Pearson correlation analysis was used to study the correlation between the levels of TGF-β1,S100-A8,IL-17 and ESR,CRP in patients with spinal tuberculosis.Results The proportion of hypertension and tuberculosis in the study group was higher than that in the control group(P<0.05),and there was no significant difference in other indicators between the two groups(P>0.05).Compared with the control group,the levels of TGF-β1,S100-A8,IL-17,ESR and CRP in the study group were increased(P<0.05).The levels of TGF-β1,S100-A8 and IL-17 were positively correlated with ESR and CRP(P<0.05).ROC curve analysis showed that the area under the curve,sensitivi-ty and specificity of TGF-β1,S100-A8 and IL-17 in the diagnosis of spinal tuberculosis were 0.907,97.1%and 74.3%,respectively,and the diagnostic efficiency was high.Conclusion The combination of TGF-β1,S100-A8 and IL-17 has a better diagnostic efficacy,and it is positively correlated with ESR and CRP in patients with spinal tuberculosis.

In April 2025,the European Association for the Study of the Liver(EASL)released an updated edition of clinical practice guidelines on Wilson's disease,and compared with the 2012 edition,the updated guidelines perform detailed elaboration and updates on clinical manifestations,diagnostic algorithms,treatment strategies,and monitoring protocols,emphasize the role of serum exchangeable copper in the diagnosis and monitoring of Wilson's disease,and provide the reference ranges for clinical application.The updated guidelines also recommend and summarize the drugs for symptomatic treatment of neuropsychiatric symptoms,add a dedicated section on transitioning pediatric patients to adult care,and discuss the optimal timing,multidisciplinary team composition,and implementation frameworks of the transition plan.These updates fully reflect the latest evidence and the development of clinical needs in the diagnosis and treatment of Wilson's disease.This article gives an excerpt of the recommendations in the guidelines.

Objective To explore the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) accompanied with KMT2D gene mutation and the impact of its co-mutated genes on prognosis. Methods Clinical data of 155 newly diagnosed DLBCL patients were obtained. The second-generation sequencing method was used to detect 475 hotspot genes, including KMT2D mutation. Patients were divided into the KMT2D mutation group and KMT2D wild-type group based on the presence or absence of KMT2D gene mutation. Clinical characteristics, differences in co-mutated genes, and survival differences between the two groups were compared. Results The frequency of KMT2D mutation was 31%, which is predominantly observed in elderly patients (P=0.07) and less in the double-expressor phenotype (P=0.07). Compared with the KMT2D wild-type group, KMT2D gene mutation was associated with higher co-mutation rates of CDKN2A (OR=2.82, P=0.01) and BCL2 (OR=3.84, P=0.016), while being mutually exclusive with MYC gene mutation (OR=0.11, P=0.013). In univariate survival analysis, no statistically significant difference in overall survival (OS) was found between the KMT2D mutation group and the wild-type group (P=0.54). Further analysis of the prognostic significance of KMT2D with other gene mutations indicated that patients with KMT2D^mutBTG2^mut had poorer OS than those with KMT2D^wt BTG2^mut (P=0.07) and KMT2D^wt BTG2^wt (P=0.05). On the contrary, patients with KMT2D^mut CD79B^mut had better OS than those with KMT2D^mut CD79B^wt (P=0.09), with no prognostic impact observed for other co-mutated genes. Multivariate Cox regression analysis revealed that Ann Arbor stages Ⅲ and Ⅳ (HR=2.751, 95%CI: 1.169-6.472, P=0.02), elevated LDH levels (HR=2.461, 95%CI: 1.396-4.337, P=0.002), Ki-67 index>80% (HR=1.875, 95%CI: 1.066-3.299, P=0.029), and KMT2D^mutBTG2^mut(HR=4.566, 95%CI: 1.348-15.471, P=0.015) were independent risk factors for OS in patients with DLBCL (P<0.05). Conclusion DLBCL patients with KMT2D mutation often have multiple gene mutations, among which patients with a co-mutated BTG2 gene have poor prognosis.

In April 2025， the European Association for the Study of the Liver （EASL） released an updated edition of clinical practice guidelines on Wilson’s disease， and compared with the 2012 edition， the updated guidelines perform detailed elaboration and updates on clinical manifestations， diagnostic algorithms， treatment strategies， and monitoring protocols， emphasize the role of serum exchangeable copper in the diagnosis and monitoring of Wilson’s disease， and provide the reference ranges for clinical application. The updated guidelines also recommend and summarize the drugs for symptomatic treatment of neuropsychiatric symptoms， add a dedicated section on transitioning pediatric patients to adult care， and discuss the optimal timing， multidisciplinary team composition， and implementation frameworks of the transition plan. These updates fully reflect the latest evidence and the development of clinical needs in the diagnosis and treatment of Wilson’s disease. This article gives an excerpt of the recommendations in the guidelines.

The key points of the update of the content related to colorectal cancer and anal cancer in the Chinese Anti-Cancer Association (CACA) Guidelines for Integrative Oncology 2025 Edition (hereinafter referred to as the CACA 2025 Guidelines) include 4 aspects. In terms of epidemiology, the latest data on the incidence and mortality of colorectal cancer in China have been updated, and the recommended screening age has been adjusted. In diagnosis, the application of enhanced MRI examination in diagnosis has been optimized, and the recommendation for peripheral blood microsatellite instability (MSI) detection has been added. In terms of treatment, in surgical treatment, the total mesorectal excision of the right colon, the safety of the Natural Orifice Specimen Extraction Surgery (NOSES) technique, the applicable range of robotic surgery, and the high-level evidence-based medical evidence of transanal total mesorectal excision (taTME) have been newly added, and the principles of surgical treatment have been added as well. In medical treatment, the role of circulating tumor DNA (ctDNA) in treatment decision-making has been supplemented. The application of dual immunotherapy in advanced patients has been recommended, and the application of third-line and subsequent-line treatments in advanced patients has been newly added. The guidelines improved the principle of preoperative neoadjuvant radiotherapy for rectal cancer, changed the indication of short-course radiotherapy, and added a variety of chemoradiotherapy combinations and recommendations for the timing of surgery. In addition, the follow-up programs for colorectal cancer and anal canal cancer are clarified, and nutritional therapy, traditional Chinese medicine rehabilitation therapy and nursing care for sequelae are emphasized, which provide more scientific and comprehensive guidance for the diagnosis and treatment of colorectal cancer and anal canal cancer.

The key points of the update of the content related to colorectal cancer and anal cancer in the Chinese Anti-Cancer Association (CACA) Guidelines for Integrative Oncology 2025 Edition (hereinafter referred to as the CACA 2025 Guidelines) include 4 aspects. In terms of epidemiology, the latest data on the incidence and mortality of colorectal cancer in China have been updated, and the recommended screening age has been adjusted. In diagnosis, the application of enhanced MRI examination in diagnosis has been optimized, and the recommendation for peripheral blood microsatellite instability (MSI) detection has been added. In terms of treatment, in surgical treatment, the total mesorectal excision of the right colon, the safety of the Natural Orifice Specimen Extraction Surgery (NOSES) technique, the applicable range of robotic surgery, and the high-level evidence-based medical evidence of transanal total mesorectal excision (taTME) have been newly added, and the principles of surgical treatment have been added as well. In medical treatment, the role of circulating tumor DNA (ctDNA) in treatment decision-making has been supplemented. The application of dual immunotherapy in advanced patients has been recommended, and the application of third-line and subsequent-line treatments in advanced patients has been newly added. The guidelines improved the principle of preoperative neoadjuvant radiotherapy for rectal cancer, changed the indication of short-course radiotherapy, and added a variety of chemoradiotherapy combinations and recommendations for the timing of surgery. In addition, the follow-up programs for colorectal cancer and anal canal cancer are clarified, and nutritional therapy, traditional Chinese medicine rehabilitation therapy and nursing care for sequelae are emphasized, which provide more scientific and comprehensive guidance for the diagnosis and treatment of colorectal cancer and anal canal cancer.

Objective:To analyze the clinical characteristics of mannose phosphate isomerase-congenital disorders of glycosylation (MPI-CDG) and evaluated the outcomes following D-mannose treatment.Methods:This case-series study analyzed clinical manifestations, laboratory findings, imaging results, genetic data, and outcomes after D-mannose therapy in 5 children with MPI-CDG diagnosed at the Children′s Hospital of Fudan University between December 2014 and December 2024.Results:The age of onset ranged from 0.3 to 0.4 years in all 5 children, who initially presented with diarrhea and hypoglycemia. Associated manifestations included short stature (3 cases), anemia (3 cases), splenomegaly (3 cases), hepatomegaly (4 cases), elevated transaminases (4 cases), and hypoalbuminemia (4 cases). Liver pathology revealed hepatic fibrosis in 3 cases. Genetic testing identified 8 variants in the MPI gene, including 2 novel variants. Following D-mannose treatment, diarrhea and hypoglycemia resolved within 1-2 weeks in all children, with concurrent improvement in anemia. Notably except for Patient 1, who developed progressive splenomegaly, worsening hepatic fibrosis, and portal hypertension despite persistently normal transaminase and albumin levels, the other 4 children showed improvement in transaminase levels, resolution of hypoalbuminemia and amelioration of imaging abnormalities.Conclusions:MPI-CDG typically manifests in infancy with diarrhea and hypoglycemia, often accompanied by multi-system involvement. D-mannose treatment significantly improves metabolic abnormalities and most organ damages. However, close surveillance of liver status is warranted due to the risk of hepatic fibrosis progression in some cases.

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.