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.

A 19-year old male patient with multiple traumatic amputations of all digits and destructive injury in one hand caused by a cement mixer was admitted in the Department of Orthopaedics, 920 Hospital, Joint Logistics Support Force, in February 2017. In the emergency surgery, the severed thumb and a bundle of severed index, middle and ring fingers were successfully replanted using super Flow-through technique with transfer of a free anterolateral thigh perforator flap (ALTPF). The little finger was abandoned. The donor site of the flaps were sutured directly. In stage II surgery, bilateral metatarsal tendon transfer and right sural nerve transfer were performed to rebuild the motor and sensory functions of the replanted digits. At 2 years of postoperative follow-up, the texture of the replanted 1st-4th digits and transferred flap in right hand was soft without rupture, and the sensation was restored to S 2+. Some digital flexion and extension were restored, which enable the patient to fulfil the most essential requirement in daily life. According to the Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association, the functional recovery was fear. Only a linear scar remained at the donor site of thigh.

A 19-year old male patient with multiple traumatic amputations of all digits and destructive injury in one hand caused by a cement mixer was admitted in the Department of Orthopaedics, 920 Hospital, Joint Logistics Support Force, in February 2017. In the emergency surgery, the severed thumb and a bundle of severed index, middle and ring fingers were successfully replanted using super Flow-through technique with transfer of a free anterolateral thigh perforator flap (ALTPF). The little finger was abandoned. The donor site of the flaps were sutured directly. In stage II surgery, bilateral metatarsal tendon transfer and right sural nerve transfer were performed to rebuild the motor and sensory functions of the replanted digits. At 2 years of postoperative follow-up, the texture of the replanted 1st-4th digits and transferred flap in right hand was soft without rupture, and the sensation was restored to S 2+. Some digital flexion and extension were restored, which enable the patient to fulfil the most essential requirement in daily life. According to the Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association, the functional recovery was fear. Only a linear scar remained at the donor site of thigh.

Objective:To investigate the effect of ultrasonic debridement combined with hyperbaric oxygen on bacterial clearance and microcirculation of diabetic foot ulcer wound.Methods:A total of 98 patients with diabetic foot ulcer who received conservative treatment in the Department of Vascular Surgery of Longkou People Hospital were selected as the research subjects and divided into three groups. The Group A (32 cases) received standard treatment; the Group B (30 cases) received standard treatment + hyperbaric oxygen therapy; the Group C (36 cases) received standard treatment + ultrasonic debridement + hyperbaric oxygen therapy. On the day 0, 7, 14, and 21, the changes of wound area were calculated by millimeter graph paper method, and the ulcer healing rates were also calculated. The bacterial clearance rates of ulcer wound were calculated by quantitative bacterial wound culture method. The microcirculation of ulcer wound was measured by Laser Doppler Perfusion Imaging (LDPI). The limb pains before and after treatment were evaluated by limb pain score and intermittent claudication score.Results:After 3 courses of treatment, the transcutaneous oxygen partial pressures and the wound blood flows of the 3 groups were significantly higher than those before treatment, and the percutaneous oxygen partial pressure and wound blood flow of the Group C after treatment were significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 14th and 21st day after treatment, the ulcer areas of the Group C were significantly lower than those of the Group A and the Group B, and the ulcer healing rate of Group C was significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 7th, 14th, and 21st day after treatment, the bacterial quantity in the ulcer tissue of the Group C was significantly lower than those in the Group A and the Group B ( P<0.05). After 3 courses of treatment, the scores of intermittent claudication and limb pain in the three groups were significantly lower than those before treatment, and the scores of limb pain and intermittent claudication in the Group C were significantly lower than those in the Group A and the Group B after treatment ( P<0.05). Conclusion:Hyperbaric oxygen combined with ultrasonic debridement can effectively remove bacteria in diabetic foot ulcer wound, promote microcirculation, and help ulcer wound healing. It is worthy of clinical application.

Objective:To investigate the effect of ultrasonic debridement combined with hyperbaric oxygen on bacterial clearance and microcirculation of diabetic foot ulcer wound.Methods:A total of 98 patients with diabetic foot ulcer who received conservative treatment in the Department of Vascular Surgery of Longkou People Hospital were selected as the research subjects and divided into three groups. The Group A (32 cases) received standard treatment; the Group B (30 cases) received standard treatment + hyperbaric oxygen therapy; the Group C (36 cases) received standard treatment + ultrasonic debridement + hyperbaric oxygen therapy. On the day 0, 7, 14, and 21, the changes of wound area were calculated by millimeter graph paper method, and the ulcer healing rates were also calculated. The bacterial clearance rates of ulcer wound were calculated by quantitative bacterial wound culture method. The microcirculation of ulcer wound was measured by Laser Doppler Perfusion Imaging (LDPI). The limb pains before and after treatment were evaluated by limb pain score and intermittent claudication score.Results:After 3 courses of treatment, the transcutaneous oxygen partial pressures and the wound blood flows of the 3 groups were significantly higher than those before treatment, and the percutaneous oxygen partial pressure and wound blood flow of the Group C after treatment were significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 14th and 21st day after treatment, the ulcer areas of the Group C were significantly lower than those of the Group A and the Group B, and the ulcer healing rate of Group C was significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 7th, 14th, and 21st day after treatment, the bacterial quantity in the ulcer tissue of the Group C was significantly lower than those in the Group A and the Group B ( P<0.05). After 3 courses of treatment, the scores of intermittent claudication and limb pain in the three groups were significantly lower than those before treatment, and the scores of limb pain and intermittent claudication in the Group C were significantly lower than those in the Group A and the Group B after treatment ( P<0.05). Conclusion:Hyperbaric oxygen combined with ultrasonic debridement can effectively remove bacteria in diabetic foot ulcer wound, promote microcirculation, and help ulcer wound healing. It is worthy of clinical application.

Objective:To investigate the clinical efficacy and mechanism of atorvastatin and Lipo-prostaglandin E1 (LipoPGE1) combined with hyperbaric oxygen (HBO) in the treatment of diabetic lower extremity vascular disease.Methods:A total of 194 patients with diabetic lower extremity ischemic disease received conservative treatment at the Department of Vascular Surgery of Longkou People’s Hospital from October 2016 to October 2019 were included into a retrospective analysis, who were divided into observation group ( n=102) and control group ( n=92) according to the treatment. The control group was treated with atorvastatin and LipoPGE1 on the basis of conventional symptomatic treatment, while the observation group was treated with HBO on the basis of that of the control group. The peak systolic velocity (Vmax), resistance index (RI), and ankle brachial index (ABI) of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery were measured before and after treatment by color Doppler ultrasound. The skin temperature and transcutaneous oxygen partial pressure (TcPO 2) were recorded before and after treatment. The levels of inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme-linked immunosorbent assay (ELISA) and that of C-reactive protein (CRP) was detected by fluorescence method. The whole blood high, low, and medium shear rate, plasma viscosity, and fibrinogen (Fib) of the two groups were detected by digital noninvasive hemodynamic detector. Results:After 3 courses of treatment, the skin temperature, TcPO 2, and ABI of the two groups were significantly higher than those before treatment, and the skin temperature, TcPO 2, and ABI of the observation group were significantly higher than those of the control group ( P<0.05). The limb pain score and intermittent claudication score of the two groups were significantly lower than those before treatment; and after treatment, the limb pain score and intermittent claudication score of the observation group were significantly lower than those of the control group ( P < 0.05). The Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the two groups were significantly higher than those before treatment, and the RI was significantly lower than that before treatment; and after treatment, the Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the observation group were significantly higher than those of the control group, and the RI was significantly lower than that of the control group ( P<0.05). The levels of serum TNF- α, IL-6, and CRP of the two groups were significantly lower than those before treatment; and after treatment, the levels of TNF-α, IL-6, and CRP of the observation group were significantly lower than those of the control group ( P < 0.05). The whole blood high, low, and medium shear rate, plasma viscosity, and Fib of the two groups were significantly lower than those before treatment; and after treatment, those of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P< 0.05). Conclusion:Atorvastatin and LipoPGE1 combined with HBO can significantly improve the clinical symptoms of the patients with diabetic lower extremity vascular disease and restore the damaged neurovascular function, which is mainly achieved by reducing the inflammatory factors and improving the level of hemorheology of the patients with diabetic lower extremity vascular disease.

Objective:To investigate the clinical efficacy and mechanism of atorvastatin and Lipo-prostaglandin E1 (LipoPGE1) combined with hyperbaric oxygen (HBO) in the treatment of diabetic lower extremity vascular disease.Methods:A total of 194 patients with diabetic lower extremity ischemic disease received conservative treatment at the Department of Vascular Surgery of Longkou People’s Hospital from October 2016 to October 2019 were included into a retrospective analysis, who were divided into observation group ( n=102) and control group ( n=92) according to the treatment. The control group was treated with atorvastatin and LipoPGE1 on the basis of conventional symptomatic treatment, while the observation group was treated with HBO on the basis of that of the control group. The peak systolic velocity (Vmax), resistance index (RI), and ankle brachial index (ABI) of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery were measured before and after treatment by color Doppler ultrasound. The skin temperature and transcutaneous oxygen partial pressure (TcPO 2) were recorded before and after treatment. The levels of inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme-linked immunosorbent assay (ELISA) and that of C-reactive protein (CRP) was detected by fluorescence method. The whole blood high, low, and medium shear rate, plasma viscosity, and fibrinogen (Fib) of the two groups were detected by digital noninvasive hemodynamic detector. Results:After 3 courses of treatment, the skin temperature, TcPO 2, and ABI of the two groups were significantly higher than those before treatment, and the skin temperature, TcPO 2, and ABI of the observation group were significantly higher than those of the control group ( P<0.05). The limb pain score and intermittent claudication score of the two groups were significantly lower than those before treatment; and after treatment, the limb pain score and intermittent claudication score of the observation group were significantly lower than those of the control group ( P < 0.05). The Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the two groups were significantly higher than those before treatment, and the RI was significantly lower than that before treatment; and after treatment, the Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the observation group were significantly higher than those of the control group, and the RI was significantly lower than that of the control group ( P<0.05). The levels of serum TNF- α, IL-6, and CRP of the two groups were significantly lower than those before treatment; and after treatment, the levels of TNF-α, IL-6, and CRP of the observation group were significantly lower than those of the control group ( P < 0.05). The whole blood high, low, and medium shear rate, plasma viscosity, and Fib of the two groups were significantly lower than those before treatment; and after treatment, those of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P< 0.05). Conclusion:Atorvastatin and LipoPGE1 combined with HBO can significantly improve the clinical symptoms of the patients with diabetic lower extremity vascular disease and restore the damaged neurovascular function, which is mainly achieved by reducing the inflammatory factors and improving the level of hemorheology of the patients with diabetic lower extremity vascular disease.

Objective To evaluate the efficacy and safety of epalrestat, an aldose reductase inhibitor, and epalrestat plus methylcobalamine on diabetic peripheral neuropathy, as compared with methylcobalamine. Methods A total of 444 subjects with diabetic neuropathy were enrolled in the study, and divided into methylcobalamine group ( n= 145 ) , epalrestat group ( n = 143 ) , and methylcobalamine combined with epalrestat group ( n = 156 ) . Therapeutic efficacay was assessed in terms of clinical symptoms and physical examinations by using Michigan Neuropathy Screening Instrument ( MNSI ) , and electrophysiological assessments. Results After 4 to 12-weeks′treatment, symptoms and signs of neuropathy ( using MNSI ) are significantly improved in the three groups ( P<0. 01). The mean changes of MNSI ( questionnaire) score from baseline were higher in epalrestat group and methylcobalamine combined with epalrestat group as compared with that of methylcobalamine group(P<0. 05), but no difference was detected in the change of MNSI ( physical examination ) score from baseline among three groups. After treatment for 12 weeks, motor nerve conduction velocity ( MNCV ) was significantly improved in epalrestat group and methylcobalamine combined with epalrestat group(P<0. 05), but no difference was detected in MNCV at 12 week among three groups(P>0. 05). Conclusion Epalrestat is effective and safe in the treatment of diabetic neuropathy. Furthermore, epalrestat is more efficacious in ameliorating symptoms and MNCV of neuropathy than methylcobalamine. However, while no improved efficacy is shown with the combined treatment.