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: Lymph node metastasis in papillary thyroid cancer (PTC) is closely associated with tumor recurrence and patient survival. However, current technologies have limited sensitivity in detecting occult cervical lymph node metastases. Identifying accurate molecular markers for predicting PTC metastasis holds significant clinical value. This study aims to analyze WNT10A expression in PTC and its clinical significance, and to explore the role of WNT10A gene knockdown in PTC cell proliferation, invasion, and metastasis. METHODS: The expression of WNT10A in thyroid carcinoma was analyzed using the Gene Expression Profiling Interactive Analysis (GEPIA) and University of Alabama at Birminghara Cancer data analysis Portal (UALCAN) databases. Real-time RT-PCR was used to measure WNT10A mRNA levels in tumor and adjacent normal tissues from 32 PTC patients. Immunohistochemistry was conducted on 158 PTC specimens to assess WNT10A protein expression and its correlation with clinicopathological features. In vitro experiments were performed using K1 and TPC-1 cell lines. Cell proliferation was assessed using the Celigo system and methyl thiazolyl tetrazolium (MTT) assays; apoptosis was measured via flow cytometry; invasion and metastasis were evaluated using scratch and Transwell assays. A xenograft model was established in nude mice to observe tumor growth, and tumor weight and volume were compared between cell lines. Differentially expressed genes regulated by WNT10A were identified via mRNA sequencing, followed by Gene Ontology (GO) and ingenuity pathway analysis (IPA). Real-time PCR and Western blotting were used to validate the effects of WNT10A on key downstream mRNA and protein in the Tec kinase signaling pathway. RESULTS: WNT10A mRNA expression was significantly higher in thyroid cancer tissues compared to adjacent normal tissues according to GEPIA and UALCAN (both P<0.01). The real-time RT-PCR result showed that WNT10A mRNA expression in PTC tissues was high than that in adjacent tissues (P<0.01). Immunohistochemistry revealed significantly higher WNT10A protein expression in PTC tissues compared to adjacent tissues (P<0.01), and its expression correlated with multifocality, extrathyroidal invasion, and lymph node metastasis. WNT10A knockdown significantly inhibited proliferation, altered cell cycle distribution, and increased apoptosis in K1 and TPC-1 cells (all P<0.01). WNT10A silencing also reduced migration and invasion abilities in both cell lines. In vivo, WNT10A knockdown in TPC-1 cells suppressed tumor formation in nude mice. GO analysis and IPA suggested that the Tec kinase signaling pathway was a key downstream target of WNT10A. RT-PCR and Western blotting confirmed that WNT10A knockdown downregulated the expression of key genes (STAT3, MAPK8, TNFRSF21, and AKT2) in this pathway. CONCLUSIONS WNT10A is highly expressed in PTC and is associated with tumor proliferation, invasion, and metastasis. Its tumor-promoting effects may be mediated through suppression of the Tec kinase signaling pathway.
Humans ; Cell Proliferation ; Thyroid Cancer, Papillary/pathology* ; Thyroid Neoplasms/metabolism* ; Animals ; Wnt Proteins/metabolism* ; Neoplasm Invasiveness ; Mice ; Cell Line, Tumor ; Female ; Male ; Mice, Nude ; Apoptosis ; Lymphatic Metastasis ; Middle Aged ; Cell Movement ; Adult

OBJECTIVES: Increasing detection of low-risk papillary thyroid carcinoma (PTC) is associated with overdiagnosis and overtreatment. N6-methyladenosine (m⁶A)-mediated microRNA (miRNA) dysregulation plays a critical role in tumor metastasis and progression. However, the functional role of m⁶A-miRNAs in PTC remains unclear. This study aims to elucidate the regulatory mechanism of m⁶A-miR-139-5p expression in PTC, determine its association with PTC metastasis, and evaluate its potential as a diagnostic biomarker for PTC metastasis, thereby providing experimental evidence for precision diagnosis and therapy. METHODS: Expression profiles of m⁶A-miRNAs were compared between the The Cancer Genome Atlas (TCGA) and GSE130512 cohorts to identify metastasis-associated candidates. Clinical specimens from 13 metastasis and 18 non-metastasis PTC patients were analyzed to assess m⁶A-miR-139-5p expression and its correlation with metastasis. Functional experiments were conducted to investigate the effect of fat mass and obesity-associated protein (FTO) on pri-miR-139 methylation and processing, clarifying its regulatory role in miR-139-5p expression. In TPC-1 cells, MTT assays were performed to evaluate whether miR-139-5p overexpression could counteract FTO-mediated cell proliferation. Transwell invasion assays were used to determine the impact of miR-139-5p on PTC cell invasion, exploring whether it functions through the ZEB1/E-cadherin axis. RESULTS: By comparing TCGA and GSE130512 cohorts, it was found that circulating m⁶A-miR-139-5p could serve as a biological indicator for detecting PTC metastasis. Detection of 13 metastatic and 18 non-metastatic clinical specimens showed that FTO inhibited the processing of pri-miR-139 by reducing its methylation level, leading to the dysregulation of miR-139-5p in PTC (P<0.05). In TPC-1 cells, MTT assay showed that overexpression of miR-139-5p could partially reverse FTO overexpression-mediated cell proliferation (P<0.05). In addition, miR-139-5p inhibited the invasive ability of PTC cells by targeting the ZEB1/E-cadherin axis, while FTO overexpression could partially weaken this inhibitory effect. CONCLUSIONS Circulating miR-139-5p can be a potential marker for evaluating PTC metastasis. FTO affects the expression and function of miR-139-5p by regulating m⁶A modification of pri-miR-139, but its clinical value needs further verification.
Humans ; MicroRNAs/metabolism* ; Thyroid Cancer, Papillary/metabolism* ; Alpha-Ketoglutarate-Dependent Dioxygenase FTO/metabolism* ; Thyroid Neoplasms/metabolism* ; Cell Line, Tumor ; Neoplasm Metastasis ; Adenosine/genetics* ; Gene Expression Regulation, Neoplastic ; Female ; Male ; Cadherins/metabolism* ; Cell Proliferation ; Zinc Finger E-box-Binding Homeobox 1/genetics*

Objective:To analyze the influencing factors of knee joint stiffness in patients with tibial plateau fractures after arthroscopy and construct a predictive model.Methods:The clinical data of 154 patients with tibial plateau fractures from June 2020 to May 2023 in Xi'an Daxing Hospital were retrospectively analyzed. All patients were treated with arthroscopic assisted internal fixation surgery. The gender, age, body weight, fracture cause, Schatzker classification, osteoporosis, meniscus and ligament structure injury, lower limb malalignment, bone graft, knee extension device injury, internal fixation method, external fixation time, heterotopic ossification, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method were recorded. The patients were followed up for 1 year, and the occurrence of knee joint stiffness was recorded. The patients were divided into knee joint stiffness group and normal knee joint group. Multivariate Logistic regression was used to analyze the independent risk factors of knee joint stiffness after arthroscopy in patients with tibial plateau fractures. R language software package was used to construct the nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures, calibration curve was drawn, and the Bootstrap method was used to verify the model discrimination. The predictive value of model was evaluated by the receiver operating characteristics (ROC) curve.Results:Among 154 patients with tibial plateau fractures, 28 patients developed knee joint stiffness after arthroscopy (knee joint stiffness group), with an incidence rate of 18.18%; 126 patients had normal knee joints (normal knee joint group). The proportions of obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification in knee joint stiffness group were significantly higher than those in normal knee joint group, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, age, fracture cause, osteoporosis, Schatzker classification, bone graft, internal fixation method, external fixation time, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were independent risk factors for knee joint stiffness after arthroscopy in patients with tibial plateau fractures ( OR = 5.387, 4.613, 3.308, 3.178 and 4.579; 95% CI 1.207 to 24.034, 1.447 to 14.709, 1.063 to 10.291, 1.155 to 8.745 and 1.540 to 13.613; P<0.05 or <0.01). The body weight, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were used as predictors to construct a nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures. The calibration curve analysis result showed that the theoretical curve was basically consistent with the actual curve trend trajectory ( C- index = 0.861). The ROC curve analysis result showed that the model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures had good accuracy (area under curve was 0.861), with the sensitivity of 92.9% and specificity of 73.0%. Conclusions:The patients with tibial plateau fractures have the risk of knee joint stiffness after arthroscopy, which may be related to patient obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification. Based on these risk factors, a column chart risk prediction model can be constructed to visualize the risk and have certain predictive value for knee joint stiffness within 1 year after surgery.

Objective:To analyze the influencing factors of knee joint stiffness in patients with tibial plateau fractures after arthroscopy and construct a predictive model.Methods:The clinical data of 154 patients with tibial plateau fractures from June 2020 to May 2023 in Xi'an Daxing Hospital were retrospectively analyzed. All patients were treated with arthroscopic assisted internal fixation surgery. The gender, age, body weight, fracture cause, Schatzker classification, osteoporosis, meniscus and ligament structure injury, lower limb malalignment, bone graft, knee extension device injury, internal fixation method, external fixation time, heterotopic ossification, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method were recorded. The patients were followed up for 1 year, and the occurrence of knee joint stiffness was recorded. The patients were divided into knee joint stiffness group and normal knee joint group. Multivariate Logistic regression was used to analyze the independent risk factors of knee joint stiffness after arthroscopy in patients with tibial plateau fractures. R language software package was used to construct the nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures, calibration curve was drawn, and the Bootstrap method was used to verify the model discrimination. The predictive value of model was evaluated by the receiver operating characteristics (ROC) curve.Results:Among 154 patients with tibial plateau fractures, 28 patients developed knee joint stiffness after arthroscopy (knee joint stiffness group), with an incidence rate of 18.18%; 126 patients had normal knee joints (normal knee joint group). The proportions of obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification in knee joint stiffness group were significantly higher than those in normal knee joint group, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, age, fracture cause, osteoporosis, Schatzker classification, bone graft, internal fixation method, external fixation time, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were independent risk factors for knee joint stiffness after arthroscopy in patients with tibial plateau fractures ( OR = 5.387, 4.613, 3.308, 3.178 and 4.579; 95% CI 1.207 to 24.034, 1.447 to 14.709, 1.063 to 10.291, 1.155 to 8.745 and 1.540 to 13.613; P<0.05 or <0.01). The body weight, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were used as predictors to construct a nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures. The calibration curve analysis result showed that the theoretical curve was basically consistent with the actual curve trend trajectory ( C- index = 0.861). The ROC curve analysis result showed that the model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures had good accuracy (area under curve was 0.861), with the sensitivity of 92.9% and specificity of 73.0%. Conclusions:The patients with tibial plateau fractures have the risk of knee joint stiffness after arthroscopy, which may be related to patient obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification. Based on these risk factors, a column chart risk prediction model can be constructed to visualize the risk and have certain predictive value for knee joint stiffness within 1 year after surgery.

Objective:To investigate the iodine nutrition level and the prevalence of thyroid nodules in pregnant women in Hubei Province, and to provide a basis for prevention and treatment of iodine deficiency disorders.Methods:According to the requirements of the National Iodine Deficiency Disorders Monitoring Program (2016 Edition), a cross-sectional survey of iodine nutrition status of pregnant women ( n = 321) was conducted from July to October 2020 in two mountainous counties (Tongcheng County and Xingshan County) and two plain counties (Liangzihu District and Xinzhou District) in Hubei Province. Among them, there were 43, 114, and 164 pregnant women in the early, middle, and late stages of pregnancy, respectively. Edible salt samples and once random urine samples were collected to detect salt iodine and urinary iodine, and thyroid ultrasound was performed to calculate the detection rate of thyroid nodules. Results:The coverage rate of iodized salt, qualified rate of iodized salt, and consumption rate of qualified iodized salt in Hubei Province were 99.69% (320/321), 95.94% (307/320) and 95.64% (307/321), respectively. The median urinary iodine level for pregnant women was 164.80 μg/L. Among them, the median urinary iodine levels in Liangzihu District, Tongcheng County, Xinzhou District, and Xingshan County were 175.90, 178.25, 155.80 and 143.00 μg/L, respectively. There was a statistically significant difference in urinary iodine levels among different regions ( H = 8.51, P = 0.037). The median urinary iodine levels of pregnant women in the early, middle, and late stages of pregnancy were 187.20, 144.45, and 172.05 μg/L, respectively. There was no statistically significant difference in urinary iodine levels among pregnant women in different stages of pregnancy ( H = 2.94, P = 0.230). Urinary iodine < 150, 150 - < 250, 250 - < 500, ≥500 μg/L accounted for 45.48% (146/321), 33.33% (107/321), 19.63% (63/321), 1.56% (5/321), respectively. The detection rate of thyroid nodules was 16.82% (54/321), and the goiter rate was 0.93% (3/321). Conclusions:In 2020, Hubei Province is in an appropriate state of iodine, and there are still a considerable proportion of pregnant women in a state of iodine deficiency. The detection rate of thyroid nodules is relatively low. It is necessary to continuously monitor the iodine nutrition of pregnant women, strengthen health promotion on the hazards of iodine deficiency during pregnancy, and minimize maternal and infant health damage caused by iodine deficiency.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Objective:To investigate the iodine nutrition level and the prevalence of thyroid nodules in pregnant women in Hubei Province, and to provide a basis for prevention and treatment of iodine deficiency disorders.Methods:According to the requirements of the National Iodine Deficiency Disorders Monitoring Program (2016 Edition), a cross-sectional survey of iodine nutrition status of pregnant women ( n = 321) was conducted from July to October 2020 in two mountainous counties (Tongcheng County and Xingshan County) and two plain counties (Liangzihu District and Xinzhou District) in Hubei Province. Among them, there were 43, 114, and 164 pregnant women in the early, middle, and late stages of pregnancy, respectively. Edible salt samples and once random urine samples were collected to detect salt iodine and urinary iodine, and thyroid ultrasound was performed to calculate the detection rate of thyroid nodules. Results:The coverage rate of iodized salt, qualified rate of iodized salt, and consumption rate of qualified iodized salt in Hubei Province were 99.69% (320/321), 95.94% (307/320) and 95.64% (307/321), respectively. The median urinary iodine level for pregnant women was 164.80 μg/L. Among them, the median urinary iodine levels in Liangzihu District, Tongcheng County, Xinzhou District, and Xingshan County were 175.90, 178.25, 155.80 and 143.00 μg/L, respectively. There was a statistically significant difference in urinary iodine levels among different regions ( H = 8.51, P = 0.037). The median urinary iodine levels of pregnant women in the early, middle, and late stages of pregnancy were 187.20, 144.45, and 172.05 μg/L, respectively. There was no statistically significant difference in urinary iodine levels among pregnant women in different stages of pregnancy ( H = 2.94, P = 0.230). Urinary iodine < 150, 150 - < 250, 250 - < 500, ≥500 μg/L accounted for 45.48% (146/321), 33.33% (107/321), 19.63% (63/321), 1.56% (5/321), respectively. The detection rate of thyroid nodules was 16.82% (54/321), and the goiter rate was 0.93% (3/321). Conclusions:In 2020, Hubei Province is in an appropriate state of iodine, and there are still a considerable proportion of pregnant women in a state of iodine deficiency. The detection rate of thyroid nodules is relatively low. It is necessary to continuously monitor the iodine nutrition of pregnant women, strengthen health promotion on the hazards of iodine deficiency during pregnancy, and minimize maternal and infant health damage caused by iodine deficiency.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

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.