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.

Male ; Humans ; Liquid Chromatography-Mass Spectrometry ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Varicocele/diagnosis* ; Biomarkers

By applying "homeostasis" to the study of the meridian and collateral system， the concept of meridian and collateral homeostasis has been proposed which refers to a balanced and stable state of meridian and collateral system， and plays an important role in maintaining body health and can provide a reference for the diagnosis and treatment of diseases. Phenomics realizes the cross-scale correlation from micro-phenotypic data， such as genome， proteome， and metabolome， to macro-phenotypic data， such as physiological state， behavioral activities， and external manifestations. From the perspective of phenomics， this paper proposes a meridian and collateral homeostasis dynamic mapping model of "macroscopic signs and microscopic expression". This model combines macro signs such as the four examinations of traditional Chinese medicine （TCM）， biophysical indicators of acupoints， and micro expression information such as genes， proteins， and metabolism， and systematically investigates the relationship between meridian and collateral homeostasis and health and disease， thereby providing ideas and references for the identification of pre-disease states as well as precise diagnosis and treatment in TCM.

Objective:To evaluate the clinical application of an angle gauge in internal fixation with proximal femoral nail antirotation (PFNA) for femoral intertrochanteric fracture.Methods:A retrospective analysis was carried out in the 54 elderly patients with intertrochanteric fracture of the femur who had been treated with PFNA internal fixation from February 2016 to August 2018 at Department of Orthopedic Trauma, Central Hospital of Shengli Oilfield. In the experimental group of 25 patients whose PFNA internal fixation was assisted by an angle gauge to measure the anteversion angle, there were 9 males and 16 females with an age of 74.4 years ± 4.6 years, and 7 cases of type 31-A1, 11 cases of type 31-A2, and 7 cases of type 31-A3 by the AO classification; in the control group of 29 patients whose PFNA internal fixation was not assisted by an angle gauge, there were 9 males and 20 females with an age of 74.4 years ± 3.9 years, and 9 cases of type 31-A1, 16 cases of type 31-A2, and 4 cases of type 31-A3 by the AO classification. The 2 groups were compared in terms of operation time, corrections of anteversion angle, intraoperative X-ray exposure times and Harris hip scores at the last follow-up.Results:There were no significant differences between the 2 groups in their preoperative general data, indicating they were compatible( P>0.05). Compared with the control group, the experimental group showed significantly shorter operation time (64.0 min ± 6.5 min versus 72.7 min ± 3.9 min), significantly fewer corrections of anteversion angle (2.8±1.2 versus 4.7±1.5) and significantly fewer X-ray exposure times(7.0±1.2 versus 11.6±1.6) (all P<0.05). This cohort was followed up for 6 to 24 months (average, 11 months). By the Harris hip scores at the last follow-up, therewere 22 excellent cases, 2 good cases and one fair case in the experimental group, and 23 excellent cases, 4 good cases and one poor case in the control group, showing an insignificant difference between the 2 groups ( P>0.05). Conclusion:Application of an angle gauge to assist PFNA internal fixation can lead to shorter operation time, fewer corrections of anteversion angle and fewer X-ray exposure times in the treatment of femoral intertrochanteric fracture.

Objective To assess the feasibility,safety and efficacy of primary PCI in elderly patients with AMI.Methods Three hundred and sixty-four AMI patients were divided into ≥75 years old group (n=90) and ＜75 years old group (n=274).The successful operation rate,preoperative complication rate,mortality and incidence of major adverse cardiovascular events (MACE) were recorded during their hospital stay time.Results The successful operation rate was 94.4％,the postoperative TIMI 3 blood flow rate was 87.8％,and the preoperative complication rate was 10.0 ％ in ≥75 years old group.The mortality and incidence of MACE were significantly higher in ≥75 years old group than in＜75 years old group during the hospital stay time (12.2％ vs 2.9％,P =0.001;16.7 ％ vs 5.1％,P =0.000).Conclusion Transradial primary PCI is a safe,feasible and effective therapy for ≥75 years old AMI patients.

Objective To explore the therapeutic effects and mechanisms of umbilical cord mesenchymal stem cells(UC-MSCs)implantation on knee osteoarthritis(OA)in rabbits. Methods The healthy adult New Zealand rabbits were divided into control group(n=4),OA model group(n=4),and treatment group(n= 4).OA model was induced by 4% papain injection(0.1 ml/kg for 2 times),and treatment group were treated with UC-MSCs implantation(1 ml,1×105/L).At 2 weeks after papain injection for preparation of osteoarthritis model,rabbits knee joints were examined by MRI,and synchrony serum levels of IL-6 and-8,MMP-3 and-13 were tested.At 3 weeks after papain injection for OA,1×106/L 1 ml UC-MSCs were injected into articular cavity in treatment group,and normal saline was injected into articular cavity in blank control group and OA model group.At 2 weeks and 4 weeks after the treatment,serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested respectively.At 4 weeks after the treatment,knee joints were reexamined again by MRI.After this,the rabbits were sacrificed and synovium and articular cartilage were taken out for HE and immunohistochemistry examination.Serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested by ELISA method. Results The levels of inflammatory cytokines such as IL-6,IL-8,MMP-3,MMP-13 were significantly higher in model group 〔(44.7 ± 14.5)μg/L,(7.6 ± 2.5)μg/L,(16.5 ± 4.3)μg/L,(4.50 ± 1.20)μg/L〕and in treatment group 〔(43.9 ± 15.2)μg/L,(9.8 ± 2.9μg/L),(18.3 ± 4.9) μg/L,(4.80 ± 1.80)μg/L〕than in control group〔(20.8 ± 11.2)μg/L,(1.2 ± 0.6)μg/L,(2.8 ± 0.9) μg/L,(0.02 ± 0.02)μg/L〕(all P < 0.05).The levels of IL-6,IL-8,MMP-3,MMP-13 were significantly lower after UC-MSCs treatment〔(23.8 ± 11.4)μg/L,(2.4 ± 1.3)μg/L,(10.5 ± 3.4)μg/L,(0.50 ± 0.20)μg/L〕than before treatment(all P<0.05).Based on magnetic resonance imaging,the treatment group versus model group showed an improved coarse cartilage surface,thickened subchondral bone and synovium,and decreased volume of joints effusion.Pathological finding showed lower levels of inflammatory reaction in cartilage and synovium in the treatment group versus model group.Immunohistochemistry showed lower levels of IL-6 and MMP-13(all P<0.05). Conclusions The inflammatory response of cartilage and synovial tissue induces OA progress,and the inflammation factors play a significant role in OA progress.UC-MSCs could protect cartilage and synovial membrane of joints and inhibit the inflammatory response.Therefore,this study provides new therapy method for OA.

Objective To investigate the effect and the mechanism of parecoxib sodium pretreatment on permeability of blood-brain barrier in a rat model of focal cerebral ischemia-reperfusion injury.Methods Sixty male SD rats weighing 300g were randomly divided into 5 groups (n=12 each):sham operation group (group S);focal cerebral I/R group (group I/R);parecoxib sodium 5 mg/kg pretreatment group (group L);parecoxib sodium7.5mg/kg pretreatment group (group M);parecoxib sodium 10 mg/kg pretreatment group (group H) Middle cerebral artery occlusion models were made by reforming Longa suture method in SD rats.Thirty minutes before ischemia,rats in group L,M and H were injected with 5 mg/kg、7.5 mg/kg and 10 mg/kg parecoxib sodium through the internal jugular vein.Group S and group I/R received equal volume of normal saline.ELISA technique was used to determine the content of S100 β,TNF-α,IL-1 β in Plasma.The changes of cerebral water content and the Evans Blue exudation from brain capillaries were observed.Results Pretreated with parecoxib sodium (5mg/kg、7.5 mg/kg and 10 mg/kg),the content of S100 β,TNF-α,II-1 β in plasma were reduced.The cerebral water content and the EB in brain were reduced.Pretreated with parecoxib sodium 10 mg/kg,Longa scores were reduced.Conclusion Pretreatment with Parecoxib can protect blood-brain barrier against focal cerebral I/R injury by inhibition of the inflammatory reaetion.

Objective To investigate the effects of silencing TSG-6 gene modified bone marrow mesenchymal stem cells (BMSC) transplantation on liver allotransplantation rejection in rats.Methods BMSC and KCs were isolated from rats and cultured in complete medium.We down-regulated TSG-6 expression of BMSC with lentiviral vectors carrying short hairpin RNA (LV3-shTSG-6).TSG-6mRNA and protein level of BMSC were tested respectively by quantitative real-time PCR and western blot analysis.After co-cuhured between BMSC and KCs,the expression of TNF-α and TSG-6 in cell supernatants were tested.Then,we established the orthotopic liver transplantation models in rats,the rats of each group were killed at 1 days,3 days and 7 days after operation.The serum levels of AST,ALT,TBIL,γ-GGT,TNF-α,IL-6 and IL-4 were tested with ELISA in each group,TSG-6mRNA and protein level of liver tissues obtained from each group were tested by quantitative real-time PCR and western blot analysis.The 1iver tissues of each group were stained with HE,then microstructure of liver tissues were observed under light microscope.The postoperative survival rates in other rats of each group were observed.Results The lentivirus transfection efficiency of mesenchymal stem cells was beyond 70 percent;After co-cultured between BMSC and KCs,the expression of TSG-6 in TSG-6-shRNA-BMSC + KCs group supernatant was significantly lower in different time point than that in BMSC + KCs group and TSG-6-NC-BMSC + KCs group (P ＜0.05),and the expression of TNF-α peak in BMSC + KCs group and TSG-6-NC-BMSC + KCs group supernatants were at 6 hours,which were significandy lower than those at 12 hours (P ＜0.05),but the expression of TNF-α in TSG-6-shRNABMSC + KCs group at 12 hours was significantly higher than those in BMSC + KCs group and TSG-6-NC-BMSC +KCs group (P ＜0.05);After transplantation,the serum levels of AST,ALT,TBIL,γ-GGT,TNF-α and IL-6 in TSG-6-shRNA-BMSC group was significantly higher than those in TSG-6-NC-BMSC group and BMSC group in different time point (P ＜ 0.05),but had no significant difference compared with PBS group;The serum levels of IL-4 in TSG-6-shRNA-BMSC group,TSG-6-NC-BMSC group and BMSC group was significantly higher than that in PBS group(P ＜ 0.05),but TSG-6-shRNA-BMSC group compared with TSG-6-NC-BMSC group and BMSC group,the serum levels of IL-4 was significantly lower (P ＜ 0.05);In pathological changes,we found that the degree of liver rejection in TSG-6-shRNA-BMSC group and PBS group were seriously obvious,and were graded Ⅱ-Ⅲ with Banff schedule;Comparation of postoperative survival time in each group,TSG-6-shRNA-BMSC group and PBS group were (16.6 ±4.6) d and (15.4 ± 6.7) d respectively,which were signifcantly lower than those in TSG-6-NCBMSC group (69.6 ± 28.1) d and BMSC group (69.2 ± 28.2) d (P ＜ 0.05).Conclusion Transplantation of BMSC secreted TSG-6 could,to some extent,mitigate acute liver transplantation rejection.

OBJECTIVETo compare the effects of clopidogrel combined with dihydropyridine calcium-channel blockers (CCBs) or non-dihydropyridine CCBs on coronary artery disease (CAD) in elderly patients.

METHODSThe study cohort was defined as all patients ≥60 years old hospitalized for CAD with the prescription of clopidogrel between January 2001 and February 2011. The primary endpoint was death of all causes, and the secondary endpoints were nonfatal myocardial infarction (MI), hospitalization for unstable angina, stroke, transient ischemic attack, or repeat revascularization (PCI or coronary artery bypass graft).

RESULTSA total of 1021 patients were enrolled, among whom 402 patients were prescribed with clopidogrel and 619 with clopidogrel combined with CCB (dihydropyridine in 547 and non-dihydropyridine in 72). In clopidogrel group and clopidogrel with CCB group, the incidence density of death was 50.55 per thousand and 42.02 per thousand, respectively. The crude RR was 0.83 (95%CI: 0.55-1.26), and the multivariable-adjusted RR was 0.47 (95%CI: 0.14-1.6), showing no statistical significance in the rate of deaths of call causes between the two groups (P>0.05); the incidence density of composite thromboembolic events showed no significant difference between the two groups, either (P>0.05). After weighting of the propensity score, the patients with clopidogrel coadministered with non-dihydropyridine CCB showed a significant increase in composite thromboembolic events than those taking dihydropyridine CCB, with a SMRW-adjusted OR of 1.97 (95%: 1.2-3.23, P=0.007). No significant difference was observed in death or composite thromboembolic events between Pgp-inhibiting CCBs and non-Pgp-inhibiting CCBs.

CONCLUSIONCompared with clopidogrel without CCB, clopidogrel with CCB does not increase the mortality or composite thromboembolic events in elderly CAD patients, but clopidogrel combined with non-dihydropyridine CCB is associated with significantly increased composite thromboembolic events in comparison with dihydropyridine CCB.

Aged ; Aged, 80 and over ; Calcium Channel Blockers ; therapeutic use ; Cohort Studies ; Coronary Artery Disease ; drug therapy ; Drug Therapy, Combination ; Humans ; Middle Aged ; Propensity Score ; Retrospective Studies ; Ticlopidine ; analogs & derivatives ; therapeutic use