The objective of this study is to analyze the current status of clinical research in the field of metabolic and bariatric surgery in China.This analysis will include research hotspots and development trends.The study will also provide references for the future development of this discipline.
Methods
A predefined search strategy was employed to identify studies related to bariatric and metabolic surgery in the China National Knowledge Infrastructure （CNKI），the Web of Science Core Collection（WOSCC），and two major clinical trial registries （ChiCTR and ClinicalTrials.gov）.The visualization analysis was conducted using CiteSpace 6.4.R1，and descriptive statistics were performed on the types and distribution of registered trials.
Results
The number of registered trials exhibited a marked upward trajectory，with a substantial surge since 2019.The analysis included a total of 521 Chinese articles and 1 657 English articles.The institution with the highest publication volume for Chinese articles was the First Affiliated Hospital of Jinan University，while for English articles，it was Shanghai Jiao Tong University.The authors with the most publications were Zhang Peng for Chinese articles and Lee Wei-Jei for English articles.The research hotspots for Chinese articles included obesity，bariatric surgery，and diabetes，while those for English articles were morbid obesity，insulin resistance，and obstructive sleep apnea.
Conclusions
Clinical research in bariatric and metabolic surgery in China has achieved significant progress in terms of the number of registered trials and published articles.However，there remains considerable room for improvement in the depth，innovation，and methodological rigor of research.In the future，it is essential to enhance the design and implementation of high-quality clinical studies to promote the sustained development of this field.
Obesity has become a globally prevalent chronic metabolic disease，posing a serious threat to public health.Traditional anti-obesity drugs have limited efficacy and numerous side effects，whereas new anti-obesity drugs，with their unique mechanisms of action and good safety profiles，offer new options for the treatment of obesity.This review will introduce the background of new anti-obesity drugs and their importance in the treatment of obesity，detailing their mechanisms of action，the latest research progress，and future development directions.
Obesity has emerged as a significant global public health challenge，with its increasing prevalence and frequent complications placing a heavy burden on healthcare systems.Effective treatment strategies are urgently needed.Currently approved weight-loss medications are scarce and have limited efficacy，while various novel weight-loss drugs，such as multi-receptor agonists and drugs targeting new pathways，are in various stages of research and clinical trials.This review categorizes these new drugs，discusses their potential mechanisms of action，evaluates their efficacy，and considers safety implications，providing crucial insights for clinical weight-loss treatments.The aim is to pave the way for new approaches and options in the treatment of obesity.
Obesity and related metabolic diseases have become a global health challenge，Metabolic and bariatric surgery is currently one of the most effective treatments for obesity and type 2 diabetes.In recent years，with the deeper understanding of the mechanisms of metabolic surgery，more and more adjunctive therapies have been proposed to optimize the surgical outcome.Tirzepatide，a novel drug for the treatment of type 2 diabetes mellitus，has attracted widespread attention because of its excellent results in improving weight management and diabetes control.This article reviews the efficacy and safety of Tirzepatide and metabolic surgery in weight loss，as well as the potential application of Tirzepatide in metabolic surgery，discusses its role before and after surgery，and looks forward to future research directions，with the aim of providing new ideas and strategies for clinical treatment.
The global prevalence of obesity has escalated at an alarming rate，with China facing an increasingly critical obesity crisis.Recognized as a chronic，relapsing，and multifaceted disease，obesity significantly compromises both the health span and quality of life of those affected.New anti-obesity agents that target the nutrient-stimulated hormone （NuSH） receptor offer a promising alternative to bariatric surgery，serving as a vital adjunct to lifestyle interventions.Clinical trials have demonstrated that these novel therapies not only achieve substantial weight reduction but also improve outcomes in type 2 diabetes，cardiovascular disease，and other obesity-related comorbidities，with their safety profiles well-established.To date，four new weight-loss medications have received approval for weight management in China，and several others are advancing through Phase Ⅲ clinical trials.Nonetheless，there remain challenges to be addressed in the clinical evaluation and application of these therapies.Looking ahead，as these challenges are progressively overcome，the potential for enhanced weight-loss outcomes，more personalized treatment options，and diverse therapeutic applications will enable these novel weight-loss drugs to play an increasingly significant role in the management of obesity.
Obesity is a chronic and recurrent disease closely related to tumors，cardiovascular diseases.Drug therapy，as an important auxiliary means of obesity treatment，has been validated for its safety and effectiveness，and can effectively reduce the weight of obese patients.With the continuous deepening of research on the pathogenesis of obesity and the transformation of related drug development paradigms，the emergence of some new weight loss drugs has provided more diverse and personalized treatment options for obese patients.This article will review the mechanism of action of new weight loss drugs that have emerged in recent years and their application progress in the treatment of obesity，in order to provide new ideas for drug therapy of obesity.
To investigate the feasibility，safety，and clinical outcomes of a transumbilical horizontal incision in single-incision laparoscopic surgery （SILS） for bariatric procedures.
Methods
Employing a retrospective and descriptive approach，this research analyzed clinical data from 336 patients treated for obesity by single-incision laparoscopic surgery at the Department of Bariatric and Metabolic Surgery in Plastic Surgery Hospital of Chinese Academy of Medical Sciences，between January 2022 and September 2023.The cohort included 87 males and 249 females，with an average age of（37.0±6.5） years and an average BMI of （39.3±6.3） kg/m².Patients' umbilical types were classified through a detailed analysis of photographs.The Scar assessment scales and Ultimate Question questionnaires were used to evaluate scar conditions and patient satisfaction.
Results
All 336 patients successfully underwent transumbilical SILS，including 321 sleeve gastrectomy （SG），6 Roux-en-Y gastric bypass （RYGB），6 single anastomosis duodeno-ileal bypass with sleeve gastrectomy （SADI-S），3 one anastomosis gastric bypass（OAGB），and 28 concomitant cholecystectomies.Umbilical types were classified as horizontal （47.3%），T-shaped （24.4%），oval （17.0%），vertical （4.8%），and distorted （6.5%）.The times for incision opening were 5±3 min and for closing 12±5 min，with total blood loss for these steps being （4±2） mL.Incision-related complications occurred in 6 patients （1.8%），including 3 cases of superficial infections （0.9%），2 of incision dehiscence （0.6%），and 1 of incisional hernia （0.3%）.The average postoperative hospital stay was （3±1）days，with 79% of patients discharged within 3 days postoperatively.The incision's Visual Analog Scale （VAS）scores on postoperative days 0，1，2，and 3 were 2.6，1.5，1.2，and 0.6，respectively.The average total score on the Scar Assessment Scale was 63.5/70，and the average score for the Ultimate Question questionnaires was 8.5/9.
Conclusions
The application of transumbilical horizontal incisions in bariatric surgery for obese patients is demonstrably effective，safe，and aesthetically pleasing，aligning well with the natural anatomy of the umbilicus.
The purpose of this study was to investigate the potential causal relationship between gastroesophageal reflux disease （GERD） and BMI，type 2 diabetes，lifestyle factors.
Methods
We extracted single nucleotide polymorphisms （SNPs） associated with various exposure factors and GERD from the GWAS database by two-sample Mendelian randomization analysis （MR），and selected appropriate instrumental variables （IVs）.The phenotypic data of IVs were searched through the Ensemble website to exclude SNPs associated with confounding factors.In this study，five statistical methods such as inverse variance weighting （IVW），weighted median （MW），MR Egger method were used for data analysis，and heterogeneity，level multi-effect test and sensitivity analysis were carried out.Odds ratio （OR） and 95 %confidence interval （CI） were used to assess the causal association between GERD and BMI，type 2 diabetes，lifestyle factors.
Results
There was a positive causal relationship between between GERD and BMI，type 2 diabetes，lifestyle factors：1.66 （95%CI：1.39～1.97），1.05 （95%CI：1.02～1.09），3.03 （95%CI：2.36～3.89），1.78（95%CI：1.57～2.03），1.22 （95%CI：1.03～1.44），respectively.
Conclusions
BMI，type 2 diabetes，smoking，drinking，and coffee intake had genetic evidence associated with GERD risk.
The increasing prevalence of obesity and type 2 diabetes mellitus （T2DM） in modern society is strongly associated.As a major risk factor for T2DM，obesity contributes to disease progression through multiple mechanisms，including adipose tissue fibrosis，activation of adipose tissue macrophage（ATM），secretion of inflammatory cytokines，dysregulation of protein kinase C ε （PKC-ε） signaling，disruptions in amino acid metabolism，and both genetic and environmental influences.Effective weight management strategies，such as lifestyle modifications，pharmacotherapy，and bariatric surgery，play a crucial role in controlling obesity and T2DM.This review summarizes recent advances in elucidating the intricate relationship between obesity and T2DM.
Bariatric surgery is currently the most effective way to treat obesity and its related metabolic diseases，and has attracted more and more attention in recent years.Dysbiosis of intestinal flora is an important trigger for metabolic inflammatory process.Bariatric surgery changes the gut microbiota as well as the weight loss，the changes of gut microbiota can improve the blood glucose，blood pressure，blood lipids and insulin resistance of patients to some extent，and help to reduce the inflammatory state and maintain the weight loss of the body.In this review，the effects of bariatric surgery on the intestinal flora，obesity，atherosclerosis （AS），T2DM and NAFLD and the related mechanisms were reviewed.
The incidence of both obesity and thyroid cancer is rising worldwide，and obesity has become an important risk factor for thyroid cancer.Studies have shown a significant correlation between obesity and thyroid cancer； however，treatment strategies for patients with both conditions are currently under-researched.This case report describes a 31-year-old female patient admitted to the hospital after a routine check-up detected insulin resistance and a thyroid tumor three days prior.The patient had a body weight of 110 kg and a body mass index （BMI） of 38.5 kg/m².Auxiliary examinations revealed elevated antithyroid peroxidase antibody （TPOAb） levels，and thyroid ultrasound showed bilateral thyroid nodules，with a suspicion of thyroid cancer based on fine-needle aspiration results.A multidisciplinary team at the Department of Bariatric and Metabolic Surgery，Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine successfully performed a single-port laparoscopic sleeve gastrectomy combined with a transoral endoscopic thyroidectomy vestibular approach for thyroid cancer in a single-stage procedure.The surgery lasted 205 minutes，and the patient had an uneventful recovery without significant complications.This combined approach effectively reduced the need for multiple anesthesia and hospital admissions while meeting the patient's needs for cosmetic outcomes and rapid recovery，offering a novel treatment option for patients with obesity and thyroid cancer.
In recent years，the da Vinci robotic-assisted bariatric and metabolic surgery，as an emerging technology，has begun to gain popularity in China，providing a new option for bariatric and metabolic surgeries.This article reports a case of a female patient with obesity，whose BMI was 38.5 kg/m².She underwent a da Vinci robotic-assisted symmetrical three-port sleeve gastrectomy （without an auxiliary port） on January 24，2024，at the Bariatric and Metabolic Surgery Center of the First People's Hospital of Yunnan Province.The article elaborates on the main steps of this surgical procedure and explores its advantages and disadvantages.
