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.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To investigate the risk factors for recurrence after modified Chevron osteotomy for hallux valgus.Methods:A total of 86 patients (102 feet) with hallux valgus who underwent modified Chevron operation in Beijing Jishuitan Hospital from December 2018 to February 2021 were retrospectively analyzed. There were 12 males (14 feet) and 74 females (88 feet), aged 50±15 years (range, 18-74 years). There were 36 cases on the right side, 34 on the left side, and 16 on the bilateral side. 4 feet were treated with Chevron osteotomy, 74 feet with modified McBride's osteotomy, 61 feet with Weil osteotomy, 24 feet with Akin osteotomy, and 23 feet with gastrocnemius aponeurotic release. At the last follow-up, hallux valgus angle (HVA) ≤15° was defined as the non-recurrence group after hallux valgus operation, and HVA>15° was defined as the recurrence group after hallux valgus operation. Compare the age, gender, preoperative HVA, the first and second intermetatarsal angles (IMA) before and after operation, the metatarsus adductus angles (MAA) before and after operation, the Meary angles before and after operation, the distal metatarsal articular angles (DMAA) before and after operation, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores before and after operation, and the rotation of the first metatarsal head between the two groups of patients. Include the indicators with statistically significant differences in the binary variable logistic regression analysis to screen for the risk factors of recurrence after modified Chevron operation for hallux valgus.Results:All patients successfully completed the operation and were followed up for 30.3±16.4 months (range, 12-52 months). Postoperative recurrence occurred in 21 feet, and the recurrence rate was 20.6% (21/102). The HVA at the last follow-up was 8.48°±4.52° in the non-recurrence group and 20.68°±3.61° in the recurrence group. In the non-recurrence group, the AOFAS ankle-hindfoot score increased from 60.31±16.62 points preoperatively to 86.89±12.79 points postoperatively ( t=-13.644, P<0.001). In the recurrent group, the AOFAS ankle-hindfoot score increased from 61.71±15.68 points preoperatively to 84.33±18.84 points postoperatively ( t=-6.082, P<0.001). The proportion of patients with preoperative Meary angle> 4° in the non-recurrence group was 52% (10/21), which was lower than 79% (64/81) in the recurrence group, and the difference was statistically significant (χ 2=6.077, P=0.014). The proportion of patients with square type of metatarsal rotation (type A) in the recurrence group was 58%(47/81), which was higher than 33%(7/21) in the non-recurrence group, and the difference was statistically significant (χ 2=4.081, P=0.043). There was no significant difference in gender, age, preoperative HVA, pre- and post-operative IMA, pre- and post-operative DMAA, pre- and post-operative MAA, or preoperative metatarsal rotation type between the two groups ( P>0.05). The results of the logistic regression analysis showed that a preoperative Meary angle ≤ 4° ( OR=3.299, P=0.024) and a non-type A metatarsal rotation pattern after operation ( OR=4.183, P=0.041) were independent risk factors for recurrence after modified Chevron operation for hallux valgus. Conclusion:Hallux valgus patients with a preoperative Meary angle ≤4° and non-type A metatarsal rotation after operation have an increased risk of recurrence following modified Chevron operation.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

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 investigate the risk factors for recurrence after modified Chevron osteotomy for hallux valgus.Methods:A total of 86 patients (102 feet) with hallux valgus who underwent modified Chevron operation in Beijing Jishuitan Hospital from December 2018 to February 2021 were retrospectively analyzed. There were 12 males (14 feet) and 74 females (88 feet), aged 50±15 years (range, 18-74 years). There were 36 cases on the right side, 34 on the left side, and 16 on the bilateral side. 4 feet were treated with Chevron osteotomy, 74 feet with modified McBride's osteotomy, 61 feet with Weil osteotomy, 24 feet with Akin osteotomy, and 23 feet with gastrocnemius aponeurotic release. At the last follow-up, hallux valgus angle (HVA) ≤15° was defined as the non-recurrence group after hallux valgus operation, and HVA>15° was defined as the recurrence group after hallux valgus operation. Compare the age, gender, preoperative HVA, the first and second intermetatarsal angles (IMA) before and after operation, the metatarsus adductus angles (MAA) before and after operation, the Meary angles before and after operation, the distal metatarsal articular angles (DMAA) before and after operation, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores before and after operation, and the rotation of the first metatarsal head between the two groups of patients. Include the indicators with statistically significant differences in the binary variable logistic regression analysis to screen for the risk factors of recurrence after modified Chevron operation for hallux valgus.Results:All patients successfully completed the operation and were followed up for 30.3±16.4 months (range, 12-52 months). Postoperative recurrence occurred in 21 feet, and the recurrence rate was 20.6% (21/102). The HVA at the last follow-up was 8.48°±4.52° in the non-recurrence group and 20.68°±3.61° in the recurrence group. In the non-recurrence group, the AOFAS ankle-hindfoot score increased from 60.31±16.62 points preoperatively to 86.89±12.79 points postoperatively ( t=-13.644, P<0.001). In the recurrent group, the AOFAS ankle-hindfoot score increased from 61.71±15.68 points preoperatively to 84.33±18.84 points postoperatively ( t=-6.082, P<0.001). The proportion of patients with preoperative Meary angle> 4° in the non-recurrence group was 52% (10/21), which was lower than 79% (64/81) in the recurrence group, and the difference was statistically significant (χ 2=6.077, P=0.014). The proportion of patients with square type of metatarsal rotation (type A) in the recurrence group was 58%(47/81), which was higher than 33%(7/21) in the non-recurrence group, and the difference was statistically significant (χ 2=4.081, P=0.043). There was no significant difference in gender, age, preoperative HVA, pre- and post-operative IMA, pre- and post-operative DMAA, pre- and post-operative MAA, or preoperative metatarsal rotation type between the two groups ( P>0.05). The results of the logistic regression analysis showed that a preoperative Meary angle ≤ 4° ( OR=3.299, P=0.024) and a non-type A metatarsal rotation pattern after operation ( OR=4.183, P=0.041) were independent risk factors for recurrence after modified Chevron operation for hallux valgus. Conclusion:Hallux valgus patients with a preoperative Meary angle ≤4° and non-type A metatarsal rotation after operation have an increased risk of recurrence following modified Chevron operation.

Objective:To evaluate the early efficacy of local application of tranexamic acid on the osteotomy surface during hallux valgus surgery in reducing postoperative occult blood loss and thus postopera-tive swelling.Methods:The data of 40 cases with hallux valgus osteotomy admitted to the Department of Foot and Ankle Surgery of Jishuitan Hospital from July 11,2022 to October 8,2022,including 5 males and 35 females were retrospectively analyzed.According to the inclusion and exclusion criteria,32 cases were finally divided into 16 cases in the observation group(application of tranexamic acid)and 16 cases in the control group(no application of tranexamic acid).The observation group was paired with the con-trol group one by one in accordance with the operation style,and the change in the anterior and posterior diameter of the first metatarsal head,the change in the circumferential diameter of the foot,the length of the first metatarsal midline and the length of the plumbline of the foot measured by postoperative CT were compared between the two groups before and after surgery,in order to evaluate the degree of swelling around the incision after the surgery.The first metatarsal midline and plumb line were measured by reference to the two auxiliary lines that intersect the soft tissue border in the sesamoid bone position to measure the rotation angle of the first metatarsal.A total of three clinicians completed the measurements of these two line segments and interobserver comparisons were performed.Results:By interobserver com-parison,the consistency of the length of the midline of the first metatarsal and the plumbline measured by CT was high and could be considered a reliable measurement.After the paired t-test,there was no statis-tical difference in the amount of changes in the anteroposterior diameter of the first metatarsal before and after surgery between the observation and control groups(P＞0.05),and the amount of changes in the circumferential diameter of the foot before and after surgery was smaller in the observation group than in the control group,which was statistically significant(P＜0.05);the length of the midline of the first metatarsal and the plumbline of the foot measured by CT after surgery was smaller in the observation group than in the control group,which was statistically significant(P＜0.05).Conclusion:Local ap-plication of tranexamic acid on the osteotomy surface during hallux valgus osteotomy can relieve postopera-tive swelling to some extent,which may be related to the fact that tranexamic acid reduces occult blood loss in the postoperative period.

Objective:To analyze the clinical data of patients with end-stage ankle and hindfoot ar-thropathy who underwent tibiotalocalcaneal(TTC)arthrodesis by the same surgeon,explore the short-and mid-term clinical results,complications and functional improvement,and discuss the clinical progno-sis and precautions of TTC arthrodesis.Methods:Retrospective analysis was made on the clinical data of 40 patients who underwent TTC arthrodesis by the same surgeon from March 2011 to December 2020.In this study,23 males and 17 females were included,with an average age of(49.1±16.0)years.All the patients underwent unilateral surgery.The clinical characteristics,imaging manifestations,main diagno-sis and specific surgical techniques of the patients were recorded.The clinical outcomes were evaluated by comparison of the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and visual analogue scale(VAS)between pre-operation and at the last follow-up.The fusion healing time,symptom improvement(significant improvement,certain improvement,no improvement or deterioration)and postoperative complications were also recorded.Results:The median follow-up time was 38.0(26.3,58.8)months.The preoperative VAS score was 6.0(4.0,7.0),and the AOFAS score was 33.0(25.3,47.3).At the last follow-up,the median VAS score was 0(0,3.0),and the AOFAS score was 80.0(59.0,84.0).All the significantly improved compared with their preoperative corre-sponding values(P＜0.05).There was no wound necrosis or infection in the patients.One patient suf-fered from subtalar joint nonunion,which was syphilitic Charcot arthropathy.The median bony healing time of other patients was 15.0(12.0,20.0)weeks.Among the included patients,there were 25 cases with significant improvement in symptom compared with that preoperative,8 cases with certain improve-ment,4 cases with no improvement,and 3 cases with worse symptoms than that before operation.Con-clusion:TTC arthrodesis is a reliable method for the treatment of the end-stage ankle and hindfoot ar-thropathy.The function of most patients was improved postoperatively,with little impact on daily life.The causes of poor prognosis included toe stiffness,stress concentration in adjacent knee joints,nonunion and pain of unknown causes.

OBJECTIVE: To investigate the effects of Danmu Extract Syrup (DMS) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and explore the mechanism. METHODS: Seventy-two male Balb/C mice were randomly divided into 6 groups according to a random number table (n=12), including control (normal saline), LPS (5 mg/kg), LPS+DMS 2.5 mL/kg, LPS+DMS 5 mL/kg, LPS+DMS 10 mL/kg, and LPS+Dexamethasone (DXM, 5 mg/kg) groups. After pretreatment with DMS and DXM, the ALI mice model was induced by LPS, and the bronchoalveolar lavage fluid (BALF) were collected to determine protein concentration, cell counts and inflammatory cytokines. The lung tissues of mice were stained with hematoxylin-eosin, and the wet/dry weight ratio (W/D) of lung tissue was calculated. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1 β in BALF of mice were detected by enzyme linked immunosorbent assay. The expression levels of Claudin-5, vascular endothelial (VE)-cadherin, vascular endothelial growth factor (VEGF), phospho-protein kinase B (p-Akt) and Akt were detected by Western blot analysis. RESULTS: DMS pre-treatment significantly ameliorated lung histopathological changes. Compared with the LPS group, the W/D ratio and protein contents in BALF were obviously reduced after DMS pretreatment (P<0.05 or P<0.01). The number of cells in BALF and myeloperoxidase (MPO) activity decreased significantly after DMS pretreatment (P<0.05 or P<0.01). DMS pre-treatment decreased the levels of TNF-α, IL-6 and IL-1 β (P<0.01). Meanwhile, DMS activated the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway and reversed the expressions of Claudin-5, VE-cadherin and VEGF (P<0.01). CONCLUSIONS DMS attenuated LPS-induced ALI in mice through repairing endothelial barrier. It might be a potential therapeutic drug for LPS-induced lung injury.
Mice ; Male ; Animals ; Proto-Oncogene Proteins c-akt/metabolism* ; Lipopolysaccharides ; Phosphatidylinositol 3-Kinases/metabolism* ; Interleukin-1beta/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Claudin-5/metabolism* ; Acute Lung Injury/chemically induced* ; Lung/pathology* ; Interleukin-6/metabolism* ; Drugs, Chinese Herbal