Background:Individual responses to weight loss interventions are highly heterogeneous. This study aimed to explore the association between serum SULT1A2 and SH2B1 levels and weight loss responses, with the goal of generating biologically relevant hypotheses. Methods:The first cohort consisted of 223 patients (102 normal weight, 52 overweight, and 69 obese), to assess associations of baselines SULT1A2 and SH2B1 with weight status. The second cohort included 49 eligible participants that completed a 4-week intermittent fasting-based weight management program. They were divided into greater weight loss group (weight loss ≥5% of initial body weight) and lesser weight loss group (weight loss <5%). Serum SULT1A2 and SH2B1 levels were detected by enzyme-linked immunosorbent assay (ELISA). Results:In the first cohort, serum SULT1A2 and SH2B1 levels varied significantly across BMI groups (P = 0.002 and P = 0.013, respectively). Both biomarkers were elevated in the overweight group compared with the normal weight group (P < 0.01 and P < 0.05). The obese group had lower SULT1A2 and SH2B1 levels than the overweight group (P < 0.05), with no significant differences versus the normal weight group. In the second cohort, SULT1A2 exhibited no association with weight loss response across both sexes. For SH2B1, male greater weight loss group exhibited significantly higher levels than lesser weight loss group (2477.1 ± 1332.2 vs. 1298.4 ± 649.6 ng/mL, P = 0.030, Hedges' g = 0.97, 95% CI: 0.01-1.97); however, this association was attenuated and did not persist after multivariable adjustment for age and baseline BMI. In females, no such difference was observed (1325.0 ± 812.3 vs. 1135.7 ± 488.3 ng/mL, P = 0.471, Hedges' g = 0.25, 95% CI: -0.49-0.99). Conclusions:Circulating SULT1A2 and SH2B1 vary across adiposity phenotypes, suggesting their potential involvement in energy metabolism. Baseline SH2B1 showed a male-specific exploratory association with early weight-loss response, although this finding was not independent of age and BMI. Collectively, these results support SH2B1 as a candidate peripheral marker of further investigation in larger, independent cohorts.

This study aimed to test the hypothesis that the NCOR2/DLL-4/Jagged-1 axis is dysregulated in cord blood of offspring from mothers with preeclampsia (PE) and gestational hypertension (GH), favoring an anti-angiogenic profile. We compared expression levels of these Notch pathway components among PE, GH, and healthy control groups to explore their potential role in fetal vascular programming. This is a prospective cohort study, including 17 mother-offspring pairs with gestational hypertension, 17 mother-offspring pairs with preeclampsia, and 34 healthy mother-offspring pairs as controls. Standardized questionnaires were used to collect family and birth information, medical records were used to collect clinical data, and Western blot was employed to measure the expression levels of NCOR2, DLL-4, and Jagged-1 in cord blood. We analyzed the differences in offspring cord blood proteins among the three groups. Cord blood protein expression revealed significant dysregulation of the NCOR2/DLL-4/Jagged-1 axis. Compared to the control group (1.36 ± 0.44), the GH (1.00 ± 0.12) and PE (0.94 ± 0.15) groups were characterized by a significant downregulation of NCOR2 (p = 0.001). Furthermore, a progressive and significant increase in DLL-4 (p = 0.001) was observed across the control (0.82 ± 0.28), GH (0.98 ± 0.17), and PE (1.27 ± 0.40) groups, which was accompanied by a significant stepwise decrease in Jagged-1 expression (control: 1.36 ± 0.28, GH: 1.02 ± 0.12, PE: 0.87 ± 0.18, p < 0.001). The cord blood levels of NCOR2 and Jagged-1 proteins were significantly decreased in offspring of PE and GH, while DLL-4 protein expression was significantly increased in offspring of PE. These findings suggest that dysregulated Notch signaling, characterized by an anti-angiogenic profile in the fetal circulation, may contribute to the vascular programming observed in offspring of preeclamptic pregnancies.

Objective:This study assessed weight self-stigma (WSS) levels and associated factors among primary school students. Methods:A cross-sectional survey was conducted in five Linhai primary schools (May-July 2023). Among 2678 students (76.6% response rate), WSS was measured using the weight self-stigma questionnaire (WSSQ), with high/low groups divided by median score. Totally, 2619 (97.8%) valid questionnaires was included in the analysis. Results:Mean WSSQ score was 21.5 ± 9.2, varying significantly by weight status: underweight (19.8 ± 8.3), normal (19.9 ± 8.3), overweight (25.5 ± 9.1), obesity (23.6 ± 10.7) (p < 0.001). Logistic regression showed higher odds of high WSS for overweight (OR = 3.00, 95%CI: 2.36-3.80), obesity (OR = 1.68, 95%CI: 1.35, 2.09), rural schooling (OR = 1.22, 95%CI: 1.01, 1.48), lower family socioeconomic status (OR = 1.30, 95% CI: 1.04, 1.61), insufficient sleep (7-8 h vs. 10 h: OR = 1.51, 95% CI: 1.17-1.97; 9 h vs. 10 h: OR = 1.23, 95% CI: 1.03-1.47), and older age (10 yrs. vs. 7-9 yrs.: OR = 1.37, 95% CI: 1.03-1.82). Conclusions:High WSS levels were prevalent among primary school students with overweight/obesity. Insufficient sleep, lower family socioeconomic status, rural schooling, and older age emerged as associated factors.

Emotional eating behaviours have not received much attention in the treatment and management of adolescent obesity in China. This study aimed to clarify the association between emotional eating and adolescents’ obese status. This school-based cross-sectional study was conducted in Taizhou, an eastern coastal city in China. Obese status was assessed using BMI Z-score (BMIZ) or waist-to-height ratio (WHtR). The Emotional Eating Scale for Chinese Adolescents (EES-CA) was used to assess emotional eating behaviours, including the dimensions of depression, anger/rage, and anxiety. Linear regression analysis was performed to examine this relationship. Multinomial logistic regression was used for graded weight status (non-overweight as reference), and binary logistic regression for abdominal obesity. Of the 1,061 registered teenagers, 881 (83.0

Background:Germline RET-p.C634Y heterozygous mutations are predominant in MEN2A, but homozygous cases and MEN2A-affected identical twins remain poorly characterized. Summary:We report two MEN2A families-a homozygous female patient and heterozygous male twins, all with RET-p.C634Y mutations and classic MEN2A manifestations. A systematic review identified 18 homozygous cases from 10 families, involving exons 11, 14, and 15, containing nine types of mutations, presenting a female (55.6%) and moderate-risk mutation (61.1%) predominance. Overall, 83.3% of the 18 patients with homozygous mutations and 30.6% of the 49 patients with heterozygous mutations from the same generation had medullary thyroid carcinoma (MTC). The homozygous mutations had a higher penetrance rate of MTC (P < 0.001) and rates of node-positive metastasis (8/15 vs. 1/15, P = 0.017). However, the comparison of the mean age at initial MTC diagnosis between patients with homozygous and heterozygous mutations [33.40 ± 17.97 (5-59) vs. 39.60 ± 12.94 (14-61) years], as well as in moderate-risk and high-risk patients with homozygous mutations [36.89 ± 16.21 (13-59) vs. 28.17 ± 20.72 (5-56) years], showed no significant differences (all P > 0.05). Additionally, the mean age at diagnosis and the incidence of pheochromocytoma did not differ significantly [(37.75 ± 18.43) vs. (39.5 ± 3.54); 27.8% vs. 13.3%; all P > 0.05]. Clustered data for identical twins diagnosed with MEN2 were also analyzed, including one with MEN2A and two with MEN2B. All three pairs of identical twins exhibited varying clinical presentations, expressivity of MEN2-related MTC and/or pheochromocytoma, and associated biomarker levels. Conclusions:Homozygous MEN2A accelerates MTC onset and increases metastasis risk, but there is no evidence of association with the development of pheochromocytoma. Consanguineous marriage could increase homozygosity in offspring and the number of affected individuals. Expressivity and clinical progression can vary even with the same genetic backgrounds, and identical twins should also be subject to individual management.

Chlamydia psittaci pneumonia (CPP) is a rare disease that is difficult to diagnose. Its clinical manifestations and chest imaging findings often overlap with those of other types of community-acquired pneumonia (CAP), and nonspecific treatment is likely to lead to rapid disease progression. This study aimed to explore the clinical and radiological differences between CPP and CAP. We enrolled 29 patients with non-severe CPP diagnosed using metagenomic next-generation sequencing, as well as 87 with CAP, who had been diagnosed between December 2019 and September 2023. The demographic, clinical, and radiological characteristics of CPP were analyzed and compared with those of CAP. Compared to the patients with CAP, those with non-severe CPP were more likely to experience fever (P = 0.034), headache (P = 0.009), asthenia (P<0.001), abnormal auscultation of the lungs (P = 0.020), and abnormal laboratory examination results—including lymphocyte count (P = 0.002), C-reactive protein (P = 0.001), aspartate aminotransferase (P<0.001), alanine aminotransferase (P<0.001), and creatine kinase levels (P<0.001). Regarding radiological characteristics, CPP predominantly showed unilateral (P = 0.003) and single-lobar (P = 0.004) involvement, whereas CAP commonly exhibited bilateral and multi-lobar involvement. CPP was more likely to be associated with air bronchograms (P = 0.026), interlobular septal thickening (P = 0.001), and bronchovascular bundle thickening (P<0.001) than CAP was. Clinical epidemiology, laboratory examination, and radiological characteristics are useful for diagnosing and differentiating CPP from CAP.

This study examined whether the addition of meal replacement (MR)-assisted intermittent fasting increases the effectiveness of a lifestyle intervention. In a nonrandomized intervention study, overweight and obese participants aged 18 to 60 years were recruited for weight management with MRs or lifestyle intervention alone (LIA) for 8 weeks. The outcomes were the percent change in body weight from baseline to weeks 4 and 8 and the associated changes in body composition (using a bioimpedance analyzer). Generalized estimating equation (GEE) models were used to compare outcomes between groups. A total of 126 participants were recruited, and 74 participants in the MR group and 46 participants in the LIA group finished the intervention protocol. The mean age was 35.4 ± 9.7 years, and 75.4

Social jetlag is very common among modern people and is an important factor influencing mental health. However, evidence regarding the relationship between social jetlag and depressive symptoms, particularly among young people (ages 10–24), is lacking. Therefore, this review aims to synthesize these studies and assess the relationship between social jetlag and depressive symptoms in young people. We searched PubMed, the Cochrane Library, Embase, and Web of Science for relevant publications from their respective inception dates to May 4, 2024. The quality of selected studies was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed using Review Manager 5.3 to calculate the combined odds ratio and correlation coefficients(r). Data were analyzed for sensitivity assessment using Stata 18.0. A total of eight studies were ultimately included in the meta-analysis. The analysis results showed that high social jetlag (≥ 2 hours) was associated with increased odds of depressive symptoms among young people(OR = 1.44, 95

Some individuals experience unexplained, persistent, or newly developed symptoms after coronavirus disease 2019 (COVID-19), known as post-COVID-19 condition (PCC). We explored the age-related prevalence, symptoms, and associated factors for PCC in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This prospective cohort study enrolled children with SARS-CoV-2 infection between December 7, 2022, and January 31, 2023. The participants were assessed via telephone 6 months post-SARS-CoV-2 diagnosis. PCC in children was diagnosed according to the World Health Organization definition. In total, 1084 patients were eligible for matching and follow-up. Eventually, 785 patients (follow-up rate, 72.4

Background: Despite numerous meta-analyses showing an association between air pollutants and diabetes, there is considerable heterogeneity between studies. Objectives: This study aims to evaluate the cumulative evidence regarding the association between air pollution and type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM) through systematic reviews and meta-analyses. Methods: Following the PRISMA 2020 guidance, a comprehensive review across three databases, including Web of Science, Embase, and PubMed, from inception to September 30, 2024. The quality of the included systematic reviews was assessed using the AMSTAR 2 tool. The research protocol has been registered in PROSPERO (CRD42024594953). Results: A total of 19 meta-analyses were identified in this review, including two articles investigating the impact of air pollution on T1DM, nine on T2DM, and ten on GDM. Due to limited data, no significant relationship between air pollution and T1DM was found. There is evidence that exposure to particulate matter (PM2.5 and PM10) may significantly increase the risk of T2DM. However, meta-analyses concerning GDM exhibit a less consistent association between air pollution and GDM risk, which varies by pollutant and duration of exposure. Conclusion: Results suggest that exposure to air pollution may increase diabetes risk to some extent, particularly for T2DM. However, due to limited available studies, further prospective cohort studies are warranted to elucidate the role of air pollutants in diabetes, particularly for T1DM. Additionally, understanding potential mechanisms by which air pollution affects diabetes is crucial for future investigations.

Objectives:Brain-derived neurotrophic factor (BDNF) is a protein essential for brain health and nutrient energy metabolism. This study aims to examine the relationship between blood BDNF levels and obesity and to assess the effect of energy-restricted diets on BDNF levels. Method:We enrolled 233 individuals with normal weight (n = 102), overweight (n = 52), and obesity (n = 69) and measured their serum BDNF levels. Totally 49 overweight and obese participants then followed a 4-week energy-restricted diet. Paired tests were used to statistically evaluate changes in serum BDNF levels before and after the diet. Based on the effectiveness of weight loss, participants were divided into high- and low-response groups. Changes in BDNF levels before and after the diet were further analyzed separately in the high- and low-response groups for both men and women. Results:Our findings showed that serum BDNF levels were significantly elevated in overweight and obese adults in the Chinese population studied (P = 0.002). Energy restriction led to a significant decrease in BDNF levels in overweight and obese participants (before: 19,605.13 ± 5,706.07 pg/ml, after: 16,437.39 ± 5,365.13 pg/ml, P < 0.001). In subgroup analysis, a reduction in BDNF levels was observed only in the female hyporesponsive group (P = 0.001). Conclusion:Serum BDNF levels were elevated in overweight and obese adults in the Chinese population, and an energy-restricted diet reduced serum BDNF. In women, failure to achieve weight loss with an energy-restricted diet may be associated with decreased BDNF levels. Maintaining stable BDNF levels, such as through exercise, should be considered to enhance weight loss outcomes. Confounding factors such as the menstrual cycle, menopausal status, and levels of physical activity should be taken into consideration in future studies.

BACKGROUND:Owing to the influence of traditional culture and the preferences of centenarians, informal caregivers are often the primary source of care. Long-term care often leads to negative reactions from caregivers. The disruption of the healthcare system during the coronavirus disease 2019 (COVID-19) pandemic, along with lockdown measures, likely increased the burden on informal caregivers and negatively affected their mental health. This study aimed to explore the well-being and related factors of long-term informal caregivers for centenarians during the COVID-19 pandemic in Taizhou, China. METHODS:A total of 74 caregivers participated in our survey, among them 63 were included in the final analysis. The Campbell Well-Being Scale, the Ontological Security Scale, and the Meaning in Life Questionnaire were used for measurement. Data were analyzed using a binary logistic regression. RESULTS:The mean well-being score of long-term informal caregivers of centenarians was 10.60±3.07. Male caregivers reported significantly higher subjective well-being than female caregivers (χ2 = 6.82, P = 0.009). Caregivers with a fixed income reported significantly higher subjective well-being than those without one (χ2 = 5.82, P = 0.016). Ontological security was significantly and positively related to the caregivers' subjective well-being after adjusting for sex and the presence or absence of a fixed income (odds ratio [OR] = 0.793, 95% confidence interval [CI]: 0.67-0.91, P = 0.002). CONCLUSION:This study suggests that the ontological security of long-term informal caregivers of centenarians is positively related to their well-being. This finding indicates that caregivers' well-being could be improved through enhancing their ontological security.

INTRODUCTION:Currently, overweight/obesity rates among children are increasing. Moreover, parents generally misunderstand their children's weight status. The correct perception of overweight/obesity in early childhood is very important for children's growth and development. The purpose of this study was to investigate parental perceptions of children's weight status. METHODS:We analyzed data from a questionnaire study conducted among 1,971 preschool children in local kindergartens from December 1, 2021, to January 31, 2022, and classified the participants as having non-overweight and overweight/obesity according to the International Obesity Task Force (IOTF) criteria. Parents were asked whether they perceived their children to have non-overweight or overweight/obesity. We analyzed the related factors that parents underestimated or overestimated their children's weight status. RESULTS:The rate of overweight/obesity in preschool children was 17.9%. Parental perceptions of children's weight status were inconsistent with children's real weight (kappa = 0.351, p < 0.001). The correctness of mother's perceptions of children's weight was higher than that of father's. Among children who were affected by overweight/obesity, 68.5% of parents underestimated their children's weights. Mothers with overweight/obesity had a 1.56 times greater risk of underestimating the children's weight than mothers who were affected by non-overweight (p = 0.010, odds ratio: 1.56, 95% confidence interval: 1.11-2.18). Children's sex and families with siblings were independent risk factors for parents to overestimate children's weight. CONCLUSION:Parents were highly likely to misinterpret the weight status of their children who were affected by overweight/obesity. Mothers with overweight/obesity were more likely to underestimate their children's weight.

BACKGROUND:Various weight management practices may have different impacts on weight loss at different time points. The aim of this study was to compare the temporal effectiveness of intermittent fasting (IF) versus calorie-restricted diet (CRD), both combined with exercise, for weight management in overweight and obese adults. METHODS:Ninety-six overweight/obese adults were voluntarily assigned to either a 5:2 IF combined with moderate exercise (IF group, n = 50) or a CRD combined with moderate exercise (CRD group, n = 46). The intervention timeline included a 4-wk weight loss phase, a 4-wk weight maintenance phase, and follow-up assessments at 6 and 12 mo. Changes in body weight, body composition, and cardiometabolic parameters were compared at different time points. RESULTS:After the 4-wk weight loss period, weight loss in the IF and CRD groups was -4.87 ± 2.32 kg and -2.82 ± 1.99 kg, respectively, with a statistically significant difference between groups (P < 0.001). During the 4-wk weight maintenance period, both reduction in body weight and improvements in body composition parameters were observed in both groups (P < 0.05). At 6- and 12-mo follow-ups, participants in both groups regained weight to varying degrees, with more fat mass regain in the CRD group. CONCLUSIONS:Our results demonstrate that both IF and CRD, combined with exercise, are effective short-term (4-wk) weight loss strategies. However, long-term follow-ups (6 and 12 mo) revealed that the IF approach may be superior for weight maintenance and show better prevention of weight regain compared with CRD.

Background:Order of eating is reportedly associated with childhood obesity. However, few studies have examined the relationship between the order of consumption of vegetables and meat/fish and childhood thinness. We aimed to investigate the effect of the order of consumption of meat/fish and vegetables on the risk of thinness in preschool children. Methods:From December 1, 2021, to January 31, 2022, 419 thinness and 1,204 normal-weight preschool children were selected from kindergartens in Taizhou, China. We used a questionnaire to determine whether the children ate vegetables or meat/fish first at mealtimes and analyzed the association between the first food consumed and children's thinness status. Results:Overall, 53.4% and 46.6% of the children ate vegetables and meat/fish first, respectively. The percentage of eating vegetables first was higher in children with thinness than that in normal weight (58.95% vs. 51.41%, P = 0.008). After adjusting for sex, parental education and parental BMI category, the odds ratio for being thin was 1.280 for children who ate vegetables first (95% confidence interval: 1.016-1.612, P = 0.036) compared with those who ate meat/fish first. Conclusions:Our study revealed that order of eating was associated with childhood thinness among preschool children. For children with thinness, we do not recommend that they eat vegetables first, but rather encourage them to eat meat/fish first.

Background. Gestational hypertension and preeclampsia are potentially linked to similar pathophysiological processes. Maternal preeclampsia increases the occurrence of early-onset neonatal thrombocytopenia. We hypothesized that maternal gestational hypertension may impact the incident early-onset neonatal thrombocytopenia. Methods. We included 538 neonates, comprising 318 and 220 neonates born to healthy mothers and those with pregnancy-induced hypertension. The minimum platelet count within 72 hours of birth was recorded for these neonates. The incidence of early-onset thrombocytopenia in neonates in relation to maternal gestational hypertension, preeclampsia, and health status was evaluated. Logistic regression analysis was conducted to assess the relationship between maternal gestational hypertension and the risk of early-onset neonatal thrombocytopenia. Results. The incidence of early-onset thrombocytopenia was significantly higher in neonates born to mothers with preeclampsia than in those born to mothers with gestational hypertension or healthy mothers. Significant differences were observed among the three groups (30.0% vs. 13.3% vs. 7.9%, p < 0.001). Maternal gestational hypertension (OR = 2.55, 95%CI 1.10–5.91) increased the risk of early-onset neonatal thrombocytopenia when compared to healthy mothers. Conclusions. Maternal gestational hypertension increases the occurrence of early-onset neonatal thrombocytopenia. Therefore, we recommend conducting platelet count screening at the early stages of neonates of mothers with gestational hypertension.

BACKGROUND:Nurses who experience verbal abuse often report negative emotions, which can affect their work status and nurse-patient relationship. However, to the best of our knowledge, no study has summarized the prevalence of verbal abuse among nurses by different perpetrators and related risk factors. AIM:This review aimed to synthesize the prevalence of verbal abuse among nurses and identify the most common sources and related risk factors. METHODS:PubMed, Web of Science, Embase, and the Cochrane Library electronic databases were searched from inception to 15 October 2024, and observational studies reporting the prevalence of verbal abuse among nurses were selected. In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Methodological quality was appraised using a revised version of the Newcastle-Ottawa Quality Assessment Scale, and the STATA software was used for meta-analysis; PROSPERO registration number: CRD42022385401. RESULTS:The search identified 458 records, of which 45 met the inclusion criteria. The overall prevalence of verbal abuse was estimated at 67% (95% CI: 61-72). Verbally abused nurses reported patients' relatives, friends (48%, 95% CI: 42-55), and physicians (39%, 95% CI: 20-58) as the main perpetrators of verbal abuse. Personal factors, work area, and work characteristics were the main factors related to verbal abuse among nurses. CONCLUSIONS:The overall prevalence of verbal abuse among nurses was more than 65%, especially in the emergency department, and South or Southeast Asian countries had a significantly lower prevalence of verbal abuse than other countries. Physicians and patients' relatives were the main sources of verbal abuse. Hospital administrators should prevent various effects of verbal abuse on nurses' physical and mental health. IMPLICATIONS FOR NURSING AND HEALTH POLICY:Developing safe workplaces and effective interventions to protect nurses is essential. Supervisors and institutions should thoroughly monitor verbal abuse. Additionally, organizations need to focus on preventive measures and provide the necessary administrative, legal, and psychological support to nurses who are exposed to verbal abuse to ensure nursing care sustainability.

To investigate the relationship between cord blood levels of Angiopoietin-1 (Ang-1) and S-endoglin (sCD105) and bronchopulmonary dysplasia (BPD) in preterm infants. Sixty-one preterm infants admitted to the neonatal intensive care unit of the study hospital between July 2021 and September 2022 were included. Cord blood was collected after the birth of premature infants. Ang-1 and sCD105 levels were quantified using the vascular endothelial growth factor enzyme-linked immunosorbent assay. Preterm infants were divided into BPD and non-BPD groups, and differences in Ang-1 and sCD105 levels between the two groups were compared. A binary logistic model was used to assess the association between low and high levels Ang-1 and BPD in preterm infants. In the study, there were 20 preterm infants with BPD (32.8

BACKGROUND:Sclerotherapy is purportedly less effective in patients with hemorrhagic than with non-hemorrhagic lymphatic malformations (LMs). We aimed to compare the efficacy of bleomycin-lauromacrogol foam (BLF) sclerotherapy in the treatment of macrocystic LMs with and without intralesional hemorrhage.METHODS:Fifty-five children with macrocystic LMs admitted to the Pediatric Surgery Department were retrospectively included. The patients were allocated into a hemorrhage group (23 cases) or a non-hemorrhage group (32 cases) based on the occurrence of an intracapsular hemorrhage. The diagnosis was confirmed by physical examination, color ultrasound, magnetic resonance imaging, and puncture findings. BLF was injected into the capsule after draining the cystic fluid under color ultrasound guidance. Patients whose lesions were unchanged or showed minor change after 1 month were treated again using the same method. Changes in lesion size and the number of treatments were recorded. Effectiveness was classified as excellent (volume reduction ≥90%), good (50%≤volume reduction<90%), or poor (volume reduction <50%).RESULTS:In the hemorrhage group, 17, 6, and 0 patients' outcomes were classified as excellent, good, and poor, respectively. The overall efficacy rate was 100%. In the non-hemorrhage group, 23, 7, and 2 patients' outcomes were classified as excellent, good, and poor, respectively. The overall efficacy rate was 93.8%. There was no significant difference in efficacy rate between groups (P = 0.767).CONCLUSIONS:BLF is an effective and safe treatment for macrocystic LMs with bleeding. The results were similar in patients with and without bleeding.LEVEL OF EVIDENCE:Treatment, Level III.

The objective of this umbrella review was to investigate comprehensive and synthesized evidence of the association between ambient air pollution and obesity based on the current systematic reviews and meta-analyses. Related studies from databases including PubMed, EMBASE, Web of Science, and the Cochrane Library, published before July 16, 2023, were considered in the analysis. All selected systematic reviews and meta-analyses were included in accordance with PRISMA guidelines. The risk of bias and the methodological quality were evaluated using the AMSTAR 2 tool. The protocol for this umbrella review was documented in PROSPERO with the registration number: CRD42023450191. This umbrella review identified 7 studies, including 5 meta-analyses and 2 systematic reviews, to assess the impacts of air pollutants on obesity. Commonly examined air pollutants included PM1, PM2.5, PM10, NO2, SO2, O3. Most of the included studies presented that air pollution exposure was positively associated with the increased risk of obesity. The impact of air pollution on obesity varied by different ambient air pollutants. This study provided compelling evidence that exposure to air pollution had a positive association with the risk of obesity. These findings further indicate the importance of strengthening air pollution prevention and control. Future studies should elucidate the possible mechanisms and pathways linking air pollution to obesity.