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.

Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.

Objective:To investigate the relationship between bone mineral density (BMD) of lumbar spine and abdominal adipose tissue in adult males.Methods:A total of 1 374 healthy male examinees in the Affiliated Hospital of Guizhou Medical University from June 2018 to September 2018 were retrospectively analyzed. The age ranged from 30 to 75 (50.9±0.30) years. Height, weight and waist circumference was measured and body mass index (BMI) was calculated. Quantitative CT (QCT) was used to measure the mean BMD value of L1 and L2. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) at the level of L2 were measured as well. According to the BMD, the males were divided into three groups: normal group, osteopenic group and osteoporosis group. One-way ANOVA was applied to compare the age, BMI, VFA and SFA among three groups. LSD- t test was used for multiple comparisons, and Pearson correlation was used to analyze the correlation between age, BMI, VFA, SFA and lumbar BMD. Results:Totally 807 healthy males were in normal group, 451 in osteopenic group and 116 in osteoporosis group. There were significant differences in age, BMI and VFA among normal group, osteopenic group and osteoporosis group ( F=237.939, 5.788, 4.919, P<0.001, 0.003, 0.007). Age and VFA was higher in osteopenic group compared with normal group, and BMI was lower in osteopenic group compared with normal group. Age was higher in osteoporosis group compared with normal group, and the BMI was lower in osteoporosis group compared with normal group. The age was higher in osteoporosis group compared with osteopenic group. The above differences were statistically significant ( P<0.05). Although there was no statistical difference in VFA and SFA between osteopenic group and osteoporosis group, the VFA and SFA was higher in osteopenic group compared with osteoporosis group. BMD of male lumbar spine was negatively correlated with age ( r=-0.542, P<0.001), VFA( r=-0.104, P<0.001), and positively correlated with BMI ( r=0.109, P<0.001). After controlling for age and BMI, BMD was still negatively correlated with VFA ( r=-0.129, P<0.05). Conclusions:Males with abdominal obesity is more likely to manifest as low bone mass. The lumbar BMD is possibly negatively correlated with visceral adipose tissue in male.

Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE. Conclusion The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.

Objective To compare the National Aeronautics and Space Administration-task load index (NASA-TLX) scores and the heart rate variability (HRV) of the female pilot cadets under different task conditions and to preliminarily investigate the characteristics of flight mental workload in females . Methods Two factors repeated measurement design was applied in this study .Twenty female pilot cadets of a flight college were chosen as subjects .Their ECG data was collected under the baseline status that they were in theoretical education and the states of preflight , taking off , approaching and landing in simulated and real flying tasks by KF1 physiological parameter recorder . The NASA-TLX scores were used to evaluate the subjective mental workload of the female cadets under baseline status and in all flying stages .The collected data are analyzed by repeated measurement ANOVA and the trends of changes in different flight stages were analyzed by Spearman's non-parameter correlation test . Results Eighteen subjects'NASA-TLX scores and 10 subjects'HR and HRV data were valid .① In analysis of the main effects of task type factors ,18 female pilot cadets'NASA-TLX scores showed significant variance between different tasks (F＝ 8 .294 , P＜0 .01) .The grand average scores both in simulated flight task (49 .47 ± 22 .69) and in real flight task (49 .68 ± 16.85)weresignificantlyhigherthanthatofbaselinestatus [(30.85±13.97);t＝3.506,3.547,P＜0 .05] .The heart rates of 10 female pilot cadets showed statistical significance between different tasks (F＝14 .615 , P＜0 .01) .The average heart rate in simulated flight task [(84 .70 ± 6 .89)beats/min] and in real flight task [(87 .73 ± 8 .79)beats/min] was also significantly higher than that of baseline status [(73 .70 ± 6 .15)beats/min ;t＝4 .029 ,5 .137 ,P＜0 .05] .②At the stage of landing ,NASA-TLX scores of 18 female flight cadets in real flight task (61 .70 ± 13 .15) and in simulated task (60 .54 ± 21.05)weresignificantlyhigherthanthatofbaselinestatus [(30.85±13.97);t＝3.506,3.547,P＜0 .05] .The HRV indexes of 10 female cadets ,including normalized unit low frequency (LFnu) , normalized unit high frequency (HFnu) ,ratio of low and high frequency bands (LF/HF) ,varied significantly in different types of task at the landing stage (F＝9 .015～12 .275 , P＜0 .01) .The LFnu in simulated flight [(90 .88 ± 4 .44)% ] and real flight tasks [(77 .22 ± 12 .04)% ] was higher than that of baseline status [(63 .75 ± 16 .87)% ;] (t＝4 .957 ,2 .462 ,P＜0 .05) ,and the HFnu of the two flight tasks [(9 .11 ± 4 .52)% ,(22 .78 ± 12 .04)% ] was lower than that of baseline status [(36 .25 ± 16 .87)% ;t＝4 .955 ,2 .460 ,P＜0 .05] .The LF/HF in this flight stage showed significant difference between simulated task (13 .51 ± 9 .51) and baseline status [(2 .40 ± 1 .66) ; t＝ 4 .088 , P＜ 0 .05] .③Both in the simulated and real flight tasks ,the NASA-TLX scores of 18 female flight cadets showed rising trend with the flight stage progress (ρ＝0 .328 ,0 .537 ,P＜0 .01) .The rising trends were also found on the LFnu and LF/HF of 10 female flight cadets (ρ＝ 0 .450～0 .631 , P＜ 0 .01) while the descending trends with flight stage progress were found on HFnu in both tasks (ρ＝ - 0 .631 ,-0 .450 ,P＜0 .01) . Conclusions The mental workload of female pilot cadets significantly increases in flight tasks as comparing to the baseline status and is significantly higher in landing stage than before flight .The simulated flight task can provide female pilot cadets basically the same mental workload as the real flight task .It is meaningful to pilot's training and related researches .

Objective To compare the National Aeronautics and Space Administration-task load index (NASA-TLX) scores and the heart rate variability (HRV) of the female pilot cadets under different task conditions and to preliminarily investigate the characteristics of flight mental workload in females . Methods Two factors repeated measurement design was applied in this study .Twenty female pilot cadets of a flight college were chosen as subjects .Their ECG data was collected under the baseline status that they were in theoretical education and the states of preflight , taking off , approaching and landing in simulated and real flying tasks by KF1 physiological parameter recorder . The NASA-TLX scores were used to evaluate the subjective mental workload of the female cadets under baseline status and in all flying stages .The collected data are analyzed by repeated measurement ANOVA and the trends of changes in different flight stages were analyzed by Spearman's non-parameter correlation test . Results Eighteen subjects'NASA-TLX scores and 10 subjects'HR and HRV data were valid .① In analysis of the main effects of task type factors ,18 female pilot cadets'NASA-TLX scores showed significant variance between different tasks (F＝ 8 .294 , P＜0 .01) .The grand average scores both in simulated flight task (49 .47 ± 22 .69) and in real flight task (49 .68 ± 16.85)weresignificantlyhigherthanthatofbaselinestatus [(30.85±13.97);t＝3.506,3.547,P＜0 .05] .The heart rates of 10 female pilot cadets showed statistical significance between different tasks (F＝14 .615 , P＜0 .01) .The average heart rate in simulated flight task [(84 .70 ± 6 .89)beats/min] and in real flight task [(87 .73 ± 8 .79)beats/min] was also significantly higher than that of baseline status [(73 .70 ± 6 .15)beats/min ;t＝4 .029 ,5 .137 ,P＜0 .05] .②At the stage of landing ,NASA-TLX scores of 18 female flight cadets in real flight task (61 .70 ± 13 .15) and in simulated task (60 .54 ± 21.05)weresignificantlyhigherthanthatofbaselinestatus [(30.85±13.97);t＝3.506,3.547,P＜0 .05] .The HRV indexes of 10 female cadets ,including normalized unit low frequency (LFnu) , normalized unit high frequency (HFnu) ,ratio of low and high frequency bands (LF/HF) ,varied significantly in different types of task at the landing stage (F＝9 .015～12 .275 , P＜0 .01) .The LFnu in simulated flight [(90 .88 ± 4 .44)% ] and real flight tasks [(77 .22 ± 12 .04)% ] was higher than that of baseline status [(63 .75 ± 16 .87)% ;] (t＝4 .957 ,2 .462 ,P＜0 .05) ,and the HFnu of the two flight tasks [(9 .11 ± 4 .52)% ,(22 .78 ± 12 .04)% ] was lower than that of baseline status [(36 .25 ± 16 .87)% ;t＝4 .955 ,2 .460 ,P＜0 .05] .The LF/HF in this flight stage showed significant difference between simulated task (13 .51 ± 9 .51) and baseline status [(2 .40 ± 1 .66) ; t＝ 4 .088 , P＜ 0 .05] .③Both in the simulated and real flight tasks ,the NASA-TLX scores of 18 female flight cadets showed rising trend with the flight stage progress (ρ＝0 .328 ,0 .537 ,P＜0 .01) .The rising trends were also found on the LFnu and LF/HF of 10 female flight cadets (ρ＝ 0 .450～0 .631 , P＜ 0 .01) while the descending trends with flight stage progress were found on HFnu in both tasks (ρ＝ - 0 .631 ,-0 .450 ,P＜0 .01) . Conclusions The mental workload of female pilot cadets significantly increases in flight tasks as comparing to the baseline status and is significantly higher in landing stage than before flight .The simulated flight task can provide female pilot cadets basically the same mental workload as the real flight task .It is meaningful to pilot's training and related researches .

ObjectiveTo summarize the experience in laparoscopy combined with choledochoscopy and duodenoscopy in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones, and to investigate its therapeutic effect. MethodsA total of 413 patients with gallstones complicated by intra- and extrahepatic bile duct stones who visited Meizhou People′s Hospital from March 2010 to March 2015 were enrolled, and according to the patients′ individual conditions, they were given laparoscopy combined with choledochoscopy and/or duodenoscopy. ResultsA total of 31 patients underwent laparoscopic cholecystectomy (LC)+laparoscopic transcystic common bile duct exploration (LTCBDE), and the success rate was 29.0% (9/31); 101 patients underwent LC+LTCBDE+T tube drainage, and the success rate was 93.1% (94/101); 96 patients underwent LC+laparoscopic common bile duct exploration (LCBDE)+choledochoscopic cholecystolithotomy+primary suture, and the success rate was 97.9% (94/96); 61 patients underwent LC+LCBDE+partial hepatectomy, and the success rate was 91.8% (56/61); 155 patients underwent endoscopic sphincterotomy (EST)+LC or LC+EST, and the success rate was 93.5% (145/155); 10 patients underwent laparoscopy+duodenoscopy+choledochoscopy (at the same time), and the success rate was 90%(9/10). Nineteen patients were converted to open surgery, and the overall success rate was 95.4％（394/413）. All the patients were cured, and there were no serious complications or deaths. ConclusionLaparoscopy combined with duodenoscopy and choledochoscopy is feasible, safe, and reliable in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones.

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Low frequency high power ultrasound is a recent addition to the list of methods for arterial angioplasty. This paper introduced the effects of the low frequency high power ultrasound and summarized the results of many experiments with its use for different kinds of arterial obstruction.
Angioplasty ; methods ; Arterial Occlusive Diseases ; surgery ; Arteriosclerosis ; surgery ; Constriction, Pathologic ; Endarterectomy ; methods ; Femoral Artery ; surgery ; Humans ; Ultrasonic Therapy ; methods