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.

McCune-Albright syndrome(MAS) is a postzygotic somatic mutation disorder caused by activating mutations in the GNAS gene, which encodes the α subunit of the stimulatory G protein. Its clinical features typically include polyostotic fibrous dysplasia, cafe-au-lait skin pigmentation, and endocrine hyperactivity, such as Cushing′s syndrome, hyperthyroidism, and growth hormone excess. Here, we report two rare cases of MAS complicated with adrenocorticotropic hormone(ACTH)-independent Cushing syndrome, and provide a review and analysis of previously reported MAS cases associated with Cushing′s syndrome.

Objective To explore the value of quantitative analysis of perirenal fat combined with Mayo adhesive probability(MAP)score in predicting the WHO/International Society of Urological Pathology(ISUP)nuclear grade of renal cell carcinoma(RCC).Methods The imaging data of 139 pathologically confirmed RCC patients were retrospectively analyzed.The patients were divided into low-grade group(grade Ⅰ-Ⅱ,n=112)and high-grade group(grade Ⅲ-Ⅳ,n=27)according to the WHO/ISUP nuclear grade.Spearman correlation analysis was used to assess the relationship between fat features and WHO/ISUP nuclear grade.The multivariate logistic regression model was used to detemine the related factors of high-grade RCC,and the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of each parameter.Results The AUC of perirenal adipose tissue(PAT)％alone for evaluating high-grade RCC was the highest,at 0.77[95％confidence interval(CI)0.69-0.83].The stepwise multivariate logistic regression model showed that perinephric fat stranding(PFS)[odds ratio(OR)=34.54,95％CI 7.60-156.87,P＜0.001],PAT％(OR=0.46,95％CI 0.32-0.66,P＜0.001),and tumor location(OR=0.26,95％CI 0.07-0.92,P=0.037)were related factors of high-grade RCC,with an AUC of 0.90(95％CI 0.84-0.94).Conclusion Quantitative analysis of perire-nal fat combined with MAP score can effectively predict the WHO/ISUP nuclear grade of RCC,providing a novel approach for per-sonalized treatment strategies to improve prognosis.

Objective:To observe the influence of trigeminal rod therapy on the stone expulsion effect after extracorporeal shock wave lithotripsy(ESWL)in patients with ureteral calculi.Methods:The clinical data of patients with ureteral calculi admitted to Weifang Traditional Chinese Medicine Hospital from May 2022 to August 2024 were retrospectively analyzed.Among them,50 patients who received ESWL ESWL combined with trigeminal rod therapy were the observation group,and 50 patients who received ESWL single treatment were randomly selected as the case control group according to the ratio of 1:1.The clinical efficacy,stone expulsion time,usage rate of analgesic drugs,incidence of renal colic and pain degree of the two groups were compared.Results:Compared with control group,the total clinical effective rate in the observation group was higher,the incidence of renal colic and usage rate of analgesic drugs were lower,and the stone expulsion time was shorter(P＜0.05).Compared with control group at 1 d,3 d and 7 d after treatment,the visual analogue scale(VAS)in the observation group was lower(P＜0.05).Conclusion:Trigeminal rod therapy can increase the total clinical effective rate after ESWL in patients with ureteral calculi,shorten the stone excretion time,reduce usage rate of analgesic drug and the risk of renal colic,and alleviate pain.

Objective:To investigate the clinical manifestations，etiology/triggers，treatment，and prognosis of children with cerebral venous sinus thrombosis（CVST）.Methods:A retrospective analysis was conducted on 36 children with CVST hospitalized at the Affiliated Children's Hospital of Xiangya School of Medicine,Central South University（Hunan Children's Hospital）from May 2014 to January 2024.A centralized telephone follow-up was performed in May 2024，and clinical data including symptoms，imaging findings，treatments，and outcomes were collected.According to the prognosis,the children were divided into favorable-prognosis group and poor-prognosis group,and the differences of clinical characteristics between the two groups were compared.The univariate Logistic regression was applied to identify factors associated with prognosis.Results:Among the 36 cases,there were 29 males and 7 females,ranging in age from 1 month to 13 years and 3 months,with a median age of 4.6(1.0,8.3) years.The common clinical manifestations included headache（24/25，96.0%），consciousness disorder（25/36，69.4%），vomiting（22/36，61.1%），seizures（14/36，38.9%），limb dysfunction（11/36，30.6%）.The leading etiologies were infection（14/36，38.9%），head trauma（8/36，22.2%），and tumors/chemotherapy（6/36，16.7%）.All 36 children underwent MRI+MRV examination of the head,and all of them had different degrees of CVST,the most commonly involved site was transverse sinus (28/36,77.8%).The favorable-prognosis group（ n=18）included 16 patients receiving anticoagulation and 2 trauma cases without anticoagulation.The poor-prognosis group（ n=18）comprised 9 anticoagulated and 9 non-anticoagulated patients.There were no significant differences in age,sex,clinical manifestations,etiology/inducement and thrombus site between the two groups ( P>0.05).However,the proportion of anticoagulant therapy in the favorable-prognosis group was higher than that in the poor-prognosis group(88.9% vs 50.0%).Among the 25 children receiving anticoagulant therapy,16 had a good prognosis (64.0%),while among the 11 children receiving no anticoagulant therapy,only 2 had a good prognosis (18.2%).The prognosis of children receiving anticoagulant therapy was better than that of those receiving no anticoagulant therapy.The difference was statistically significant ( P<0.05).Fourteen children were admitted with intracranial hemorrhage,with 8 receiving anticoagulant therapy (7 with good prognosis,accounting for 87.5%) and 6 not receiving anticoagulant therapy (only 1 with good prognosis,accounting for 12.5%).The prognosis of children receiving anticoagulant therapy was better than that of those receiving no anticoagulant therapy,and the difference was statistically significant ( P=0.026),with no increasing in intracranial hemorrhage after anticoagulant therapy.Univariate Logistic regression analysis showed that inducement/etiology,intracranial hemorrhage before treatment and prognosis were not related（ P >0.05），but anticoagulation treatment was associated with favorable outcomes（ OR=0.125，95% CI 0.017-0.614, P=0.009）. Conclusion:Infection is the primary etiology of pediatric CVST，with headache，lethargy，and vomiting as key symptoms.Transverse sinus is the most commonly involved site.Children suspected of CVST should be examined by MRI/MRV as soon as possible,and early anticoagulation therapy should be given after a clear diagnosis,so as to improve the prognosis.

Objective To explore the occurrence of acute kidney injury(AKI)in patients with Stanford type A aortic dissection(TAAD)after surgical treatment,analyze the risk factors,and construct a prediction model.Methods A retrospective case-control study was conducted on 138 TAAD patients undergoing surgical treatment in our hospital from January 2016 to June 2024.After Kidney Disease Improving Global Outcomes(KDIGO)criteria was performed within 1 week after surgery,they were divided into AKI(n=95)and non-AKI(n=43)groups.Univariate and multivariate logistic regression analyses were performed to identify the perioperative risk factors.Then a nomogram model were constructed,and receiver operating characteristic(ROC)curve was plotted to analyze its predictive efficacy.Results The incidence of postoperative AKI was 68.84%(95 cases)in the TAAD patients,including 51.58%(49 cases)of stage 3 AKI and 38.95%(37 cases)requiring continuous renal replacement therapy.The length of ICU stay,time to extubation,and abandonment of treatment were significantly higher in the AKI group than the non-AKI group(P<0.001).Multifactorial analysis showed that the monocyte count on postoperative day 1(OR=3.521)and preoperative creatinine level(OR=1.019)were independent risk factors for AKI,postoperative uric acid level(OR=1.005)was correlated with AKI,and intraoperative urine volume(OR=0.739)and globulin level at 1 d postoperatively(OR=0.781)were protective factors.The area under the ROC curve of the constructed model was 0.866,with a sensitivity of 0.811 and a specificity of 0.791.Conclusion Postoperative AKI occurrence can be reduced in TAAD patients by optimizing the intraoperative urine output,modulating the postoperative inflammatory response,and strengthening nutritional support.Our prediction model for AKI risk is of significance for early clinical identification of high-risk patients in TAAD patients after surgical treatment.

BACKGROUND: Modern acupuncture anesthesia is a combination of Chinese and Western medicine that integrates the theories of acupuncture with anesthesia. However, some clinical studies of acupuncture anesthesia lack specific descriptions of randomization, allocation concealment, and blinding processes, with subsequent systematic reviews indicating a risk of bias. OBJECTIVE: Clinical trial registration is essential for the enhancement of the quality of clinical trials. This study aims to summarize the status of clinical trial registrations for acupuncture anesthesia listed on the World Health Organization International Clinical Trials Registry Platform (ICTRP). SEARCH STRATEGY: We searched the ICTRP for clinical trials related to acupuncture anesthesia registered between January 1, 2001 and May 31, 2023. Additionally, related publications were retrieved from PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Data. Registrations and publications were analyzed for consistency in trial design characteristics. INCLUSION CRITERIA: Clinical trials that utilized one of several acupuncture-related therapies in combination with pharmacological anesthesia during the perioperative period were eligible for this review. DATA EXTRACTION AND ANALYSIS: Data extracted from articles included type of surgical procedure, perioperative symptoms, study methodology, type of intervention, trial recruitment information, and publication information related to clinical enrollment. RESULTS: A total of 166 trials related to acupuncture anesthesia from 21 countries were included in the analysis. The commonly reported symptoms in the included studies were postoperative nausea and vomiting (19.9%) and postoperative pain (13.3%). The concordance between the publications and the trial protocols in the clinical registry records was poor, with only 31.7% of the studies being fully compatible. Inconsistency rates were high for sample size (39.0%, 16/41), blinding (36.6%, 15/41), and secondary outcome indicators (24.4%, 10/41). CONCLUSION The volume of acupuncture anesthesia clinical trials registered in international trial registries over the last 20 years is low, with insufficient disclosure of results. Postoperative nausea and vomiting as well as postoperative pain, are the most investigated for acupuncture intervention. Please cite this article as: Li Y, Liu YN, Guo Z, Gu ME, Wang WJ, Zhu Y, Zhuang XJ, Chen LM, Zhou J, Li J. Current situation of clinical trial registration in acupuncture anesthesia: A scoping review. J Integr Med. 2025; 23(3): 256-263.
Humans ; Acupuncture Analgesia ; Acupuncture Therapy ; Anesthesia ; Clinical Trials as Topic ; Registries

Currently, the drug delivery system (DDS) based on nanomaterials has become a hot interdisciplinary research topic. One of the core issues is drug loading and controlled release, in which the key lever is carriers. Vaterite, as an inorganic porous nano-material, is one metastable structure of calcium carbonate, full of micro or nano porous. Recently, vaterite has attracted more and more attention, due to its significant advantages, such as rich resources, easy preparations, low cost, simple loading procedures, good biocompatibility and many other good points. Vaterite, gained from suitable preparation strategies, can not only possess the good drug carrying performance, like high loading capacity and stable loading efficiency, but also improve the drug release ability, showing the better drug delivery effects, such as targeting release, pH sensitive release, photothermal controlled release, magnetic assistant release, optothermal controlled release. At the same time, the vaterite carriers, with good safety itself, can protect proteins, enzymes, or other drugs from degradation or inactivation, help imaging or visualization with loading fluorescent drugs in vitro and in vivo, and play synergistic effects with other therapy approaches, like photodynamic therapy, sonodynamic therapy, and thermochemotherapy. Latterly, some renewed reports in drug loading and controlled release have led to their widespread applications in diverse fields, from cell level to clinical studies. This review introduces the basic characteristics of vaterite and briefly summarizes its research history, followed by synthesis strategies. We subsequently highlight recent developments in drug loading and controlled release, with an emphasis on the advantages, quantity capacity, and comparations. Furthermore, new opportunities for using vaterite in cell level and animal level are detailed. Finally, the possible problems and development trends are discussed.

The development of bone in human body and the maintenance of bone mass in adulthood are regulated by a variety of biological factors. Myocyte enhancer factor 2C (MEF2C), as one of the many factors regulating bone tissue development and balance, has been shown to play a key role in bone development and metabolism. However, there is limited systematic analysis on the effects of MEF2C on bone tissue. This article reviews the role of MEF2C in bone development and metabolism. During bone development, MEF2C promotes the development of neural crest cells (NC) into craniofacial cartilage and directly promotes cartilage hypertrophy. In terms of bone metabolism, MEF2C exhibits a differentiated regulatory model across different types of osteocytes, demonstrating both promoting and other potential regulatory effects on bone formation, with its stimulating effect on osteoclasts being determined. In view of the complex roles of MEF2C in bone tissue, this paper also discusses its effects on some bone diseases, providing valuable insights for the physiological study of bone tissue and strategies for the prevention of bone diseases.
Humans ; MEF2 Transcription Factors/physiology* ; Bone and Bones/metabolism* ; Animals ; Bone Development/physiology* ; Osteogenesis/physiology* ; Myogenic Regulatory Factors/physiology*

A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity. However, regulatory mechanisms at the translational level under cardiac stress remain poorly understood. Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction (TAC) and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy (DCM). The results showed that the heart weight to body weight ratio was significantly elevated, and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC. Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle. RNA-seq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling, metabolic processes, and signaling cascades associated with pathological cardiomyocyte growth. When combined with ribosome profiling analysis, we revealed that translation efficiency (TE) of 1,495 genes was enhanced, while the TE of 933 genes was inhibited following TAC. In DCM patients, 1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level. Although the majority of the genes were not shared between mouse and human, we identified 93 genes, including Nos3, Kcnj8, Adcy4, Itpr1, Fasn, Scd1, etc., with highly conserved translational regulations. These genes were remarkably associated with myocardial function, signal transduction, and energy metabolism, particularly related to cGMP-PKG signaling and fatty acid metabolism. Motif analysis revealed enriched regulatory elements in the 5' untranslated regions (5'UTRs) of transcripts with differential TE, which exhibited strong cross-species sequence conservation. Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.
Animals ; Humans ; Cardiomegaly/physiopathology* ; Ribosomes/physiology* ; Protein Biosynthesis/physiology* ; Mice ; Cardiomyopathy, Dilated/genetics* ; Ribosome Profiling