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.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

Objective:To evaluate the trauma center model in general hospitals for patients with severe trauma.Methods:The data of 1,248 patients with severe trauma (ISS≥16) were retrospectively analyzed who had been admitted to the trauma centers in 6 Chinese general hospitals from January 2019 through June 2020. They were 987 males and 261 females with an age of 50.4 years ± 15.4 years. Their injuries were caused by a traffic accident in 622 cases, falling from a height in 357 cases, a knife in 62 cases, and others (like a heavy object and fall) in 207 cases. Upon admission, their injury severity scores (ISS) were 24.9±8.5 and their Glasgow coma scores (GCS) 12.6±3.6. They were all treated in a scientific and standard manner by a multidisciplinary team at the trauma center of their specific general hospital. Recorded were deaths within 30 days after admission, 30-day mortality and causes of death.Results:All the patients were treated effectively. 101 deaths occurred within 30 days after admission, yielding a 30-day mortality of 8.1%. The main causes of death were severe craniocerebral injury in 56 cases, hemorrhagic shock in 26 cases, multi-organ failure in 11 cases and others in 8 cases.Conclusions:Establishment of trauma centers in China can make up for the disadvantage of over-division of clinical specialties in large general hospitals which has led to insufficient care for patients with severe trauma and multiple injuries. The trauma centers in general hospitals may be a feasible model to be popularized in treatment of patients with severe trauma and multiple injuries.

Objective To explore the role of c-Jun N-terminal protein kinase(JNK)pathway in renal tubular epithelial cells(RTEC)transdifferentiation by detecting the expression of JNK pathway in the injury of hypoxic RTEC. Methods In vitro cultured rat RTEC were randomly divided into four groups of normal control, hypoxia,inhibitors,dimethyl sulfoxide(DMSO). The groups of hypoxia,inhibitor and DMSO were placed into a vacuum tank to establish hypoxia model. The cells were harvested 6,12 and 24 h after hypoxia started. RT-PCR and Western blot test were used to detect the mRNA expressions of alpha smooth muscle actin(α- SMA)and protein expressions of JNK,pJNK and alpha SMA,respectively,in all the groups. Results Hypoxia induced significantly increased expressions of α-SMA mRNA and proteins,and JNK and pJNK proteins as well in RTEC (all P<0.05).After addition of inhibitors,the expression of α-SMA mRNA and proteins,the protein expression of pJNK in RTEC were significantly decreased(all P < 0.05)and the expression of JNK protein was significantly increased(P < 0.05). There was no significant difference in the expressions of JNK,pJNK,α-SMA in RTECs between hypoxia group and DMSO group(all P>0.05).There was a significant positive correlation between pJNK protein and α-SMA protein expression(P < 0.01). Conclusion In hypoxic RETC injury in rats,JNK pathway may be involved in the RTEC phenotype transdifferentiation.

Objective To explore the effect of overexpression of retinoic acid receptor α(RARα)on epithelial-to-mesenchymal transition(EMT)induced by hypoxia in renal tubular epithelial cells(NRK-52E).Methods The RARα lentivirus vector and negative control lentivirus vector were synthetised.The NRK-52E cells were divided into 4 groups:the normal control group,the hypoxia model group,the transfection group and the negative control group.Puro-mycin(2 mg/L)was added in transfection group and negative control group for screening after gene interference for 72 h.Then the 2 groups were subjected to hypoxia/reoxygenation,but the normal control group had no treatment. The change of cellular morphology was observed by using light microscope;the mRNA and protein expressions of RARα, E-cadherin,α -smooth muscle actin(α-SMA)in NRK-52E cells were detected by adopting reverse transcription-polymerase chain reaction(RT-PCR)and Western blot after hypoxia for 48 h.Results (1)Light microscope re-vealed that cells in both hypoxia model group and negative control group cells became atrophic and elongated,which were consistent with the morphology of myofibroblasts.But cells in transfection group cells were cubic,forming an epi-thelial monolayer.(2)Compared with the normal control group,the mRNA and protein expressions of RARα and E-cadherin in hypoxia model group were dramatically reduced(mRNA:0.58 ± 0.12 vs.1.00 ± 0.00,0.11 ± 0.00 vs. 1.00 ± 0.00,t= -0.63,767.30,all P<0.05;protein:0.63 ± 0.12 vs.1.62 ± 0.16,0.44 ± 0.22 vs.1.27 ± 0.08,t=8.61,6.19,all P<0.05),but the mRNA and protein expressions of α-SMA were higher(3.47 ± 0.83 vs.1.00 ± 0.00,1.39 ± 0.16 vs.0.64 ± 0.10,t= -5.01,-6.91,all P<0.05).(3)The mRNA and protein expressions of RARα and E-cadherin in the transfection group were significantly increased,compared with hypoxia model group(mRNA:4.69 ± 1.34 vs.0.58 ± 0.12,0.23 ± 0.00 vs.0.11 ± 0.00,q=9.13,25.48,all P<0.05;protein:1.39 ± 0.19 vs. 0.63 ± 0.12,0.87 ± 0.09 vs.0.44 ± 0.22,q=7.92,4.30,all P<0.05)and negative control group(mRNA:4.69 ± 1.34 vs.0.55 ± 0.21,0.23 ± 0.00 vs.0.12 ± 0.01,q=9.20,23.35,all P<0.05;protein:1.39 ± 0.19 vs.0.65 ±0.18,0.87 ± 0.09 vs.0.39 ± 0.21,q=7.71,4.80,all P<0.05).Conversely,the mRNA and protein levels of α-SMA were obviously lower in transfection group(1.52 ± 0.34 vs.3.47 ± 0.83,4.05 ± 0.81,0.82 ± 0.13 vs.1.39 ± 0.10,1.17 ± 0.10,q=4.88,6.33,7.50,4.61,all P<0.05).The difference in mRNA and protein expressions of RARα,E-cadherin,α-SMA between the hypoxia group and the negative control group had no statistical significance (all P>0.05).Conclusion Overexpression of RARα could alleviate EMT of renal tubular epithelial cells induced by hypoxia.

Objective To find out the display rules of the key part of the proximal femur and fracture line and obtain the best viewing position and angle by placing the femoral neck at different positions and different angles through X-ray.Methods Six dry specimens of cadaveric femur were from Department of Anatomy,Tianjin Medical University.Three models of complete femoral neck model,tin line fracture model and steel saw fracture model were made respectively.The tin line fracture model was based on the Pauwells angle,using the tin wire(1mm) wrapped around the femoral necks to make three kinds of fracture models (Pauwells angle 30°,50° and 70°);steel saw fracture model was made by hacksaw,then reposition in situ,to make three kinds of fracture models same as the tin line fracture model.The projection manner included different positions and different angles,different projection positions include:parallel with the femoral shaft,perpendicular to the femoral shaft,parallel to the femoral neck and perpendicular to the femoral neck;different projection angles included:from 40°,30°,20°,15°,10° and 5° in the head side to 5°,10°,15 °,20 °,30 °and 40° in the foot side and vertical angle 0°.For the complete femoral neck model,we observed the imaging characteristics of the key parts of the femoral head and neck (tension trabecular bone and pressure trabecular bone;lesser trochanter;intertrochanteric line;length of neck of femur and femoral head shape),looking for the display rules,and obtained the best viewing position.For tin line fracture model and steel saw fracture model,we tried to find the best display angle and position by the different projection position and angle.Results The results of complete femoral neck model:Lesser trochanter:in perpendicular to the femoral shaft position showed the best,gradually increased with the foot side deflection;tension trabecular bone and pressure trabecular bone:in parallel with the femoral shaft position 10°on the head side;intertrochanteric line:no difference between parallel with the femoral shaft with perpendicular to the femoral shaft;Femoral neck shape:deflect to both sides,head of femur was out of shape.The results of tin line fracture model:the Pauwells angle 30° model showed the best position in parallel with the femoral shaft position 20° on the head side;the Pauwells angle 50° model showed the best position in parallel with the femoral shaft position 5° on the head side;the Pauwells angle 70° model showed the best position in parallel with the femoral shaft position 10° on the head side.The results of steel saw fracture model were the same with the tin line fracture model.Conclusion There was the best viewing angles and positions for the key anatomy of the proximal femur and different Pauwells angle classification of femoral neck fracture.The image doctor could make more accurate projection,according to the different types of femoral neck fracture.

Adult ; Albumins ; metabolism ; Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; Blood Protein Disorders ; diagnosis ; Humans ; Male

Objective To investigate the value of Computed Tomography Myelography(CTM) and CT in diagnosis of in intravertebral tumors.Methods 35 tumors in the canales spinalis examined by CTM and CT and confirmed by surgical-pathologic results were retrospectively analyzed.Results 10 intramedullary(28 6%),15 intradural extramedullary(42 9%) ,8 intradural(22 9%) and 2 intra-extradural tumors(5 7%) were diagnosed respectively by CTM and CT.Conclusion CTM and plain and enhancement CT scanning can reveal the features of every kind of tumors in the canales spinalis and determine correctly respective position and nature.

Objective To investigate the effects of Compound Ganduqing Decoction(CGD) on activation and apoptosis of iron overloading hepatic stellate cells(HSC).Methods The cultured HSC-T6 cells were used for experimental cells,and were divided into normal control group,model group and CGD treatment group(in the dose of 0.08g/L).HSC model of iron overloading was induced by incubation with ammonium iron citrate.Immunohistochemical assay was used for the detection of alpha smooth muscle actin(?-SMA) expression.Quantitative polymerase chain reaction(PCR) was applied for the detection of transforming growth factor beta 1(TGF-?1) mRNA expression.TUNEL technique was used for the examination of apoptosis of HSC-T6.Electron microscope was used for the observation of ultrastructure of HSC-T6.Results In the normal control group and the model group,there showed large amount of ?-SMA expression in HSC-T6,but little apoptosis.However,in CGD group ?-SMA expression was decreased obviously,TGF-?1 mRNA expression was reduced,and apoptosis of HSC-T6 was obvious(P