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 observe the value of training about ovarian-adnexal reporting and data system((O-RADS)for risk stratification of adnexal lesions diagnostic efficacy of different seniority physicians before and after training.Methods A total of 575 O-RADS 1-5 point lesions from 470 patients who received non-contrast enhanced pelvic MR and dynamic contrast-enhanced MRI(DCE-MRI)were retrospectively included.The lesions were scored by 1 junior radiologist(radiologist A)and 1 senior radiologist(radiologist B)independently according to O-RADS risk stratification,and the results were recorded as R1 and R2,respectively.Three months later,the lesions were rescored by radiologist A and B after receiving systematic training from gynecological imaging experts,and the results were recorded as R11 and R22,respectively.Two gynecological imaging experts conducted a consensus scoring,and the results were recorded as R0.Taken O-RADS score＞3 as the criterion for malignant,the diagnostic efficacy of radiologist A and B before and after training were evaluated,while taken R0 as the reference,the intra-observer,inter-observer consistency between radiologist A and B,as well as their consistency with R0 were calculated.Results The diagnostic sensitivity and specificity of R0 was 95.21%and 93.14%,respectively.The diagnostic sensitivity of radiologist A before and after training was 92.22%and 95.21%,with specificity of 83.33%and 89.46%,respectively.For radiologist B,the sensitivity before and after training was 95.81%and 95.21%,with specificity of 92.89%and 91.91%,respectively.Good intra-observer consistency of O-RADS score was observed both in radiologist A and B,with Kappa value of 0.845 and 0.884,respectively,which also noticed between radiologist A and B,with Kappa value of 0.761,and the Kappa value of R1,R2 and R0 was 0.781 and 0.911,respectively.After training,the inter-observer consistency of radiologist A and B increased,and Kappa value of R11,R22 and R0 was 0.844 and 0.915,respectively.Conclusion Training about O-RADS for risk stratification was helpful to improving diagnostic specificity of benign and malignant adnexal lesions,especially for junior radiologists.

Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1％to 100.0％,and the proportion of values processed within 30 min increased from 80.91％to 83.42％.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.

Objective:To evaluate the relationship between postoperative delirium (POD) and concentrations of phosphatidylethanolamine-binding protein 1 (PEBP1) in cerebrospinal fluid (CSF) of elderly patients undergoing total knee and hip arthroplasty.Methods:In this case-control study, 375 elderly patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective total knee and hip arthroplasty under combined spinal-epidural anesthesia at Haian Hospital Affiliated to Nantong University from November 2022 to June 2024, were selected. The perioperative clinical data were collected. CSF was drawn before anaesthesia for determination of the concentrations of PEBP1, Abeta 42 (Aβ 42), total tau (t-tau) and phosphorylated tau (p-tau) by enzyme-linked immunosorbent assay. The occurrence of postoperative delirium was evaluated using the Confusion Assessment Method at 1-7 days after operation. The severity of POD was assessed using a Memorial Delirium Assessment Scale. The patients were divided into POD group and non-POD group based on whether POD occurred. The influencing factors of POD were analyzed using multivariate logistic regression. Mediating effects were assessed to determine whether the levels of Aβ 42, p-tau and t-tau in CSF mediated PEBP1′s effect on POD. The accuracy of CSF PEBP1 concentration in predicting POD was evaluated using the receiver operating characteristic curve. Results:Decreased concentration of Aβ 42 in CSF, decreased ratios of Aβ 42/p-tau and Aβ 42/t-tau in CSF, and increased concentrations of PEBP1, p-tau and t-tau in CSF were independent risk factors for POD ( P<0.05). The results of mediation analysis showed that the relationship between PEBP1 and POD was partially mediated by CSF Aβ 42 (15.0%) and Aβ 42/t-tau ratio (14.9%). The receiver operating characteristic curve showed that the accuracy of CSF PEBP1 concentrations in predicting the occurrence of POD was high (AUC=0.846, P<0.001). Conclusions:Preoperative elevated CSF PEBP1 concentration is a risk factor for POD. CSF Aβ 42 concentration and Aβ 42/t-tau ratio serve as key mediators in the the association between PEBP1 and POD. PEBP1 concentration is more accurate in predicting POD.

Objective To explore the value of apparent diffusion coefficient(ADC)value combined with ovarian-adnexal reporting and data system(O-RADS)MRI score in differentiating benign and malignant adnexal lesions with score 3-5.Methods The imaging data of 241 adnexal lesions with O-RADS MRI score 3-5 proved by pathology were analyzed retrospectively.The ADC values of all lesions were measured,and the optimal thresholds were determined by receiver operating characteristic(ROC)curve analysis,the comprehensive model was established using binary logistic regression analysis,the corresponding diagnostic efficacy was calculated.Results The median ADC values of the benign,borderline and malignant groups were 2.166 × 10-3 mm2/s,1.383 ×10-3 mm2/s and 0.839× 10-3mm2/s,respectively(P＜0.05).The area under the curve(AUC)of the combination of ADC value with O-RADS MRI score for differentiating benign and malignant adnexal lesions was 0.928[95％ confidence interval(CI)0.888-0.958],which was higher than that of O-RADS MRI score and ADC value alone(P＜0.05).The sensitivity and specificity of the three models in differ-entiating benign and malignant adnexal lesions were 93.5％,98.9％,83.9％,respectively;and 79.1％,58.8％,79.1％,respectively.Conclusion ADC value combined with O-RADS MRI score can be the most effective in the diagnosis of benign and malignant adnexal lesions,which is higher than O-RADS MRI score and ADC value.Compared with O-RADS MRI score,ADC value combined with O-RADS MRI score maintained good sensitivity and increased diagnostic specificity.

Objective To investigate the efficacy and mechanism of Jiedu Bushen Huoxue Prescription in intervening bone and joint damage associated with hepatolenticular degeneration(HLD)by investigating its effect on improving HLD-related bone and joint damage symptoms and on bone metabolism indicators.Methods From March 2022 to August 2022,a total of 57 patients diagnosed with HLD-related bone and joint damage admitted to the First Department of Neurology,the First Affiliated Hospital of Anhui University of Chinese Medicine were selected as the study subjects.The patients were randomly divided into an observation group(29 cases)and a control group(28 cases)using a random number table.The control group was given conventional decopper therapy combined with Alfacalcidol Soft Capsules and Alendronate Sodium Tablets,while the observation group was given additional treatment with Jiedu Bushen Huoxue Prescription based on the control group's regimen.The treatment course lasted 8 weeks.Before and after treatment,changes in the Oswestry Disability Index(ODI)score,Numerical Rating Scale(NRS)pain score,and bone mineral density(BMD)values in the two groups were observed to evaluate overall efficacy.Additionally,serum levels of interleukin 1β(IL-1β),interleukin 6(IL-6),C-terminal telopeptide of type I collagen(β-CTX),and 1,25-dihydroxyvitamin D3[1,25-(OH)2D3]in the two groups were measured before and after treatment to observe the impact on bone metabolism indicators.Results(1)After treatment,the ODI scores and NRS pain scores in both groups were significantly decreased compared to those before treatment(P＜0.05),and the decrease in the observation group was more obvious than that in the control group(P＜0.05).(2)After treatment,the BMD values of the bilateral femoral neck and lumbar vertebrae 2-4(L2-L4)in both groups were significantly increased compared to those before treatment(P＜0.05),and the increase in the observation group was more obvious than that in the control group(P＜0.05).(3)After treatment,the serum levels of IL-1β,IL-6,and β-CTX in both groups were significantly decreased(P＜0.05),while the serum levels of 1,25-(OH)2D3 were significantly increased(P＜0.05)compared to those before treatment.The decrease in IL-1β,IL-6,and β-CTX levels and the increase in 1,25-(OH)2D3 levels in the observation group were superior to those in the control group(P＜0.05).Conclusion Jiedu Bushen Huoxue Prescription has certain effect on improving the symptoms of the patients with HLD-related bone and joint damage,and it is effective on significantly alleviating bone and joint pain and improving BMD and joint function.Its mechanism may be related to the improvement of relevant bone metabolism indicators.

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 evaluate the relationship between postoperative delirium (POD) and concentrations of phosphatidylethanolamine-binding protein 1 (PEBP1) in cerebrospinal fluid (CSF) of elderly patients undergoing total knee and hip arthroplasty.Methods:In this case-control study, 375 elderly patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective total knee and hip arthroplasty under combined spinal-epidural anesthesia at Haian Hospital Affiliated to Nantong University from November 2022 to June 2024, were selected. The perioperative clinical data were collected. CSF was drawn before anaesthesia for determination of the concentrations of PEBP1, Abeta 42 (Aβ 42), total tau (t-tau) and phosphorylated tau (p-tau) by enzyme-linked immunosorbent assay. The occurrence of postoperative delirium was evaluated using the Confusion Assessment Method at 1-7 days after operation. The severity of POD was assessed using a Memorial Delirium Assessment Scale. The patients were divided into POD group and non-POD group based on whether POD occurred. The influencing factors of POD were analyzed using multivariate logistic regression. Mediating effects were assessed to determine whether the levels of Aβ 42, p-tau and t-tau in CSF mediated PEBP1′s effect on POD. The accuracy of CSF PEBP1 concentration in predicting POD was evaluated using the receiver operating characteristic curve. Results:Decreased concentration of Aβ 42 in CSF, decreased ratios of Aβ 42/p-tau and Aβ 42/t-tau in CSF, and increased concentrations of PEBP1, p-tau and t-tau in CSF were independent risk factors for POD ( P<0.05). The results of mediation analysis showed that the relationship between PEBP1 and POD was partially mediated by CSF Aβ 42 (15.0%) and Aβ 42/t-tau ratio (14.9%). The receiver operating characteristic curve showed that the accuracy of CSF PEBP1 concentrations in predicting the occurrence of POD was high (AUC=0.846, P<0.001). Conclusions:Preoperative elevated CSF PEBP1 concentration is a risk factor for POD. CSF Aβ 42 concentration and Aβ 42/t-tau ratio serve as key mediators in the the association between PEBP1 and POD. PEBP1 concentration is more accurate in predicting POD.

Aim To investigate the role of corylin in angiotensin Ⅱ(Ang Ⅱ)-induced cardiomyocyte hy-pertrophy and its underlying mechanisms.Methods An Ang Ⅱ-induced cardiomyocyte hypertrophy model was established and treated with corylin.Real-time PCR was employed to assess hypertrophic gene mRNA expression,and immunofluorescence was used to meas-ure cardiomyocyte surface area.Western blot and en-zyme activity assay kits were used to evaluate SIRT1 expression and activity.Results Corylin markedly mitigated Ang Ⅱ-induced hypertrophic gene expression and cardiomyocyte surface area enlargement.Moreo-ver,it prevented the Ang Ⅱ-mediated decline in SIRT1 protein levels and deacetylase activity.Further investi-gation indicated that corylin inhibited Ang Ⅱ-driven NF-κB transcriptional activity and the expression of its downstream target genes,such as TNF-α,IL-6,and IL-1β.Notably,SIRT1 silencing abolished the protective effects of corylin against cardiomyocyte hypertrophy,as well as its regulation of the SIRT1/NF-κB signaling pathway.Conclusion Corylin suppresses cardiomyo-cyte hypertrophy by modulating the SIRT1-dependent NF-κB signaling pathway.

Objective To explore the value of apparent diffusion coefficient(ADC)value combined with ovarian-adnexal reporting and data system(O-RADS)MRI score in differentiating benign and malignant adnexal lesions with score 3-5.Methods The imaging data of 241 adnexal lesions with O-RADS MRI score 3-5 proved by pathology were analyzed retrospectively.The ADC values of all lesions were measured,and the optimal thresholds were determined by receiver operating characteristic(ROC)curve analysis,the comprehensive model was established using binary logistic regression analysis,the corresponding diagnostic efficacy was calculated.Results The median ADC values of the benign,borderline and malignant groups were 2.166 × 10-3 mm2/s,1.383 ×10-3 mm2/s and 0.839× 10-3mm2/s,respectively(P＜0.05).The area under the curve(AUC)of the combination of ADC value with O-RADS MRI score for differentiating benign and malignant adnexal lesions was 0.928[95％ confidence interval(CI)0.888-0.958],which was higher than that of O-RADS MRI score and ADC value alone(P＜0.05).The sensitivity and specificity of the three models in differ-entiating benign and malignant adnexal lesions were 93.5％,98.9％,83.9％,respectively;and 79.1％,58.8％,79.1％,respectively.Conclusion ADC value combined with O-RADS MRI score can be the most effective in the diagnosis of benign and malignant adnexal lesions,which is higher than O-RADS MRI score and ADC value.Compared with O-RADS MRI score,ADC value combined with O-RADS MRI score maintained good sensitivity and increased diagnostic specificity.