Sleeve gastrectomy (SG) is currently the most frequently performed bariatric procedure, yet it faces limitations such as inadequate weight loss or regain, gastroesophageal reflux disease (GERD), and intrathoracic sleeve migration (ITSM), necessitating refinement. To address these shortcomings, this study proposes the novel concept of functional sleeve gastrectomy (FSG). FSG aims to systematically optimize surgical techniques to resolve these issues, achieving maximal organ function preservation, optimal weight loss outcomes, and minimal complications. The core innovations of FSG include: routine exploration of the left diaphragmatic crus; plication and narrowing of the costodiaphragmatic angle; preservation of approximately 2 cm of gastric fundal tissue proximal to the angle of His; construction of a gastric body restriction ring; initiating gastric transection 3~4 cm proximal to the pylorus; seromuscular imbrication suturing of the staple line; and omentum repositioning and fixation. Preliminary application in 12 patients demonstrates: the procedure is safe and feasible (with no severe complications); at 12 months postoperatively, mean total weight loss (%TWL) reached (34.8±7.9)% and mean excess weight loss (%EWL) was (77.2±18.9)%. Notably, none of the patients reported typical GERD symptoms. FSG may represent a novel direction for optimizing SG, However, further research evidence is still needed to prove the safety and effectiveness of FSG, so as to provide a reference basis for the promotion of this surgical method.

As the prevalence of obesity and related metabolic diseases surges, the core role of bariatric surgical case managers in long-term postoperative patient management has become increasingly prominent. This paper systematically explores the practical challenges and development paths of specialized construction in this field in China through literature analysis and policy research and proposes strategies such as establishing a standardized training system, setting up multidisciplinary collaboration platforms, optimizing resource allocation models, and strengthening comprehensive health management throughout the entire cycle. These strategies aim to provide theoretical foundations and practical references for improving the quality of specialized services.

Valvular heart disease is a condition that impairs the normal function of cardiac valves and often requires surgical intervention to improve patient outcomes. Body mass index (BMI) is a widely used international standard for assessing body fatness and overall health status. Significant changes in BMI are positively correlated with the incidence of metabolic syndrome and cardiovascular and cerebrovascular diseases, and both excessively high and low BMI may increase the risk of postoperative complications. This study aims to investigate the association between BMI and the perioperative period in patients with valvular heart disease.

This retrospective study used data from the INSPIRE database and included 972 patients undergoing cardiac valve surgery. Patients were classified into four BMI categories: underweight (<18.5 kg/m²), normal weight (18.5 kg/m²≤BMI<24.0 kg/m²), overweight (24.0 kg/m²≤BMI<28.0 kg/m²), and obese (BMI≥28.0 kg/m²). Logistic regression models were employed to assess the association between BMI and in-hospital mortality. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Restricted cubic spline (RCS) regression was applied to explore potential non-linear associations between BMI and mortality risk.

Multivariable logistic regression analysis identified cardiopulmonary bypass time, serum albumin, activated partial thromboplastin time, serum creatinine, body mass index (BMI), and continuous renal replacement therapy (CRRT) as independent predictors of postoperative mortality following cardiac valve replacement. Each 1-unit increase in BMI was associated with an 11% reduction in mortality risk (OR=0.89, 95% CI: 0.81–0.99, P=0.027). Receiver operating characteristic (ROC) curve analysis demonstrated that the combined model incorporating these variables achieved high predictive accuracy (AUC=0.857, 95% CI: 0.795–0.920), with a sensitivity of 80.36% and a specificity of 80.57%. Restricted cubic spline analysis revealed a significant non-linear association between BMI (kg/m²) and mortality, with two inflection points at 23.41 kg/m² and 29.69 kg/m². For BMI<23.42, mortality risk increased with decreasing BMI; for 23.42≤BMI<29.69, risk declined to its lowest level; and for BMI≥29.69, mortality risk tended to rise again.

Low BMI is strongly associated with perioperative mortality after cardiac valve surgery, and serves as a potential predictor of mortality risk.

To investigate the impact of case management combined with detailed dietary guidance on weight loss effect and dietary compliance in patients undergoing sleeve gastrectomy (SG).

A total of 86 patients who underwent laparoscopic sleeve gastrectomy at the Jiangnan University Medical Center between March 2023 and March 2024 were enrolled and randomly assigned to either a control group (n=43) or an observation group (n=43). The control group received routine postoperative care, while the observation group received case management combined with detailed dietary guidance in addition to routine care. Both interventions lasted for 6 months after surgery. The anthropometric parameters [weight, body mass index (BMI), and waist circumference], quality of life scores [World Health Organization Quality of Life Brief Scale (WHOQOL-BREF)], postoperative dietary compliance, and incidence of complications were compared between groups before and after the surgery.

At 3 and 6 months postoperatively, both groups showed significant improvements in body measurements compared with preoperative values (P<0.05). The observation group demonstrated significantly lower weight, BMI, and waist circumference than the control group (P<0.05). Both groups exhibited significant improvements in quality of life scores compared with baseline (P<0.05), with the observation group scoring higher on all WHOQOL-BREF scales than the control group (P<0.05). After 6 months of follow-up, the observation group demonstrated significantly higher dietary compliance than the control group (P<0.05). No postoperative complications occurred in the observation group, while the control group reported 3 cases (1 gastric leakage and 2 malnutrition). However, the between-group difference was not statistically significant.

In patients undergoing SG, case management combined with detailed dietary guidance significantly enhances dietary compliance, promotes greater improvements in anthropometric parameters and quality of life, and may help lower the risk of postoperative malnutrition.

To explore the current situation and influencing factors of nurses' biased attitude towards people with obesity, which can provide theoretical guidance for formulating measures to eliminate nurses ' weight bias.

In this study, convenience sampling method was used to select registered nurses from medical institutions in different regions from May 2021 to September 2021 for questionnaire distribution and recovery. The research tools include general information questionnaire, and the attitude towards obese people scale (ATOP). SPSS 27.0 was used to establish the database and analyze the data.

The average ATOP score of nurses was (68.21±14.40), and 30% of them scored below 60. The linear regression analysis of the influencing factors of nurses' weight bias attitude showed that the age, working years, number of metabolic diseases, hospital level and professional title of nurses had significant statistical significance on the score of ATOP scale (P<0.05 ).

In this study, nearly one-third of nurses show a negative attitude towards people with obesity. The age, working years, number of metabolic diseases, hospital level and professional title were the main influencing factors of nurses ' bias against people with obesity.

To systematically analyze the intervention effect of continuing care on the health status of patients with metabolic and bariatric surgery (MBS), in order to provide a reference basis for clinical nursing staff to formulate relevant interventions.

In accordance with the PRISMA-ScR reporting guidelines, a comprehensive and systematic search was conducted in Embase, CINAHL Plus, PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and CBM databases. The retrieval time was from inception of the database to May 1, 2025. Relevant studies were screened, summarized, analyzed, and reported according to the inclusion and exclusion criteria.

A total of 19 studies were included. The process of continuing care intervention could be summarized into six steps, including the establishment of a continuing care management team, establishment of health records and formulation of nursing plans, establishment of a communication platform for weight loss among doctors, nurses and patients in continuous nursing, standardization and visualization of health education, psychological care and regular follow-up visits. The outcome indicators mainly involved weight loss effects (BMI, body weight, waist circumference, hip circumference, blood pressure), quality of life, changes in blood glucose, psychological status (anxiety, depression), nursing satisfaction, dietary behavior control and compliance.

The content and form of continuing care intervention for MBS patients are diverse. It plays a positive role in maintaining the weight loss effect of MBS patients, improving the physical and mental health, and enhancing the quality of life. However, there is significant heterogeneity in the outcome indicators and their measure tools, and the follow-up time has not been clearly unified. In the future, the standardized process suitable for MBS patients should be explored and further verified, so as to provide evidence-based basis for clinical practice applications.

To search, evaluate and integrate the best evidence of hypoglycemia risk identification and symptom management of patients after bariatric surgery, so as to provide evidence-based basis for later management.

According to the "6S" evidence model, the relevant literature on hypoglycemia management of patients after bariatric surgery was searched by computer from BMJ Best Practice, Up To Date, Cochrane Library, CINAHL, CNKI, domestic and foreign guidelines and websites of Chinese and English databases. The search period is from establishment to 2 August 2024. Two researchers conducted rigorous quality evaluation, evidence summary and grade rating of the included literatures.

A total of 9 literatures were included, including 2 clinical decisions, 3 guidelines, 2 expert consensus, and 3 systematic reviews. The 26 best evidences were summarized from six aspects: multidisciplinary management, hypoglycemia risk factors, hypoglycemia recognition and classification, emergency treatment and follow-up, monitoring, health education and empowerment.

The best evidence for risk identification and symptom management of patients with hypoglycemia after metabolic bariatric surgery summarized in this study is scientific, but medical staff still need to consider the appropriateness and effectiveness of evidence when applying evidence, and formulate personalized management plans based on clinical scenarios and patients' wishes.

With the increasing prevalence of overweight and obesity, the negative perception and stereotypes of obese people, namely weight stigma,are becoming increasingly serious. This review summarizes the assessment tools developed both domestically and internationally for weight-related discrimination and bias from the perspectives of the public and overweight/obese people. Summarizes the content, characteristics, and application of the measurement tools, analyzes the advantages and disadvantages of different tools, provides a reference for researchers to accurately measure the weight stigma level of the two perspectives, develop the localization measurement tools, and develop the stigmatization strategies.

Amidst the escalating global epidemic of adolescent obesity and the limited efficacy of traditional interventions, Metabolic and bariatric surgery (MBS) has emerged as a highly effective treatment option. However, while MBS provides significant weight loss benefits for adolescents, it also presents new clinical challenges related to their unique physiological stage of rapid skeletal growth, posing potential risks to bone health. Currently, the long-term mechanisms by which MBS interferes with adolescent bone metabolism are not fully understood, and evidence-based data regarding its long-term skeletal safety are urgently needed. This review systematically examines the effects of MBS on bone health in adolescents with obesity, aiming to provide an evidence-based assessment of skeletal outcomes and to guide nutritional supplementation strategies postoperatively.

Intermittent fasting, also known as light fasting, is a method of adjusting diet in a specific period of time to achieve weight control, improve physical health and delay aging. As a new way to treat metabolic diseases, intermittent fasting has attracted wide attention in recent years. Relevant studies have shown that intermittent fasting has positive effects on weight loss, improvement of blood lipids, blood sugar, insulin resistance, regulation of intestinal microbial environment, anti-aging and other aspects. This paper summarizes the effectiveness of intermittent fasting in these aspects and its side effects. It provides reference for further exploring the application of intermittent fasting.

Laparoscopic sleeve gastrectomy (LSG) has become a mainstream surgical procedure for treating morbid obesity and metabolic syndrome due to its proven weight loss effects and significant benefits for obesity-related complications such as hypertension, hyperlipidemia, hyperuricemia, and polycystic ovary syndrome. It also has advantages like the relative ease of the procedure, less surgical complications, and high patient acceptance. However, as weight loss surgeries become more common, complications after sleeve gastrectomy, such as gastric fistula, bleeding, and stenosis, have gradually increased. Postoperative gastric stenosis (GS) is one of the serious complications, which can cause serious eating issues, malnutrition, and impact patients' quality of life. This article looks into how gastric stenosis happens after LSG, drawing on the latest research from both home and abroad, as well as our department's clinical experience in managing postoperative gastric stenosis. The aim is to provide doctors with a comprehensive and systematic reference for the diagnosis, treatment, and prevention of gastric stenosis after LSG, to help lower the chances of this complication and improve the postoperative quality of life for patients.

Obesity is a global health issue closely related to various digestive system tumors. Studies have shown that obesity is associated with digestive system tumors such as esophageal adenocarcinoma, gastric cancer, colorectal cancer, hepatocellular carcinoma, biliary tract cancer, and pancreatic cancer. This article elaborates on how obesity significantly increases the risk of digestive tract tumors (such as esophageal adenocarcinoma, gastric cancer, and colorectal cancer) through mechanisms such as metabolic disorders, chronic inflammation, insulin resistance, and abnormal sex hormone levels. The risk increases with the degree of obesity. Inflammatory factors secreted by fat cells can activate pro-inflammatory signaling pathways and promote tumor cell proliferation; insulin resistance leads to hyperinsulinemia, activates signaling pathways, acidifies the tumor microenvironment, and facilitates tumor invasion and metastasis; abnormal sex hormone levels activate estrogen receptors and promote tumor cell growth. In addition, obesity-induced tumor-associated macrophages (TAMs) and cancer-associated adipocytes (CAAs) further promote tumor development by secreting pro-inflammatory factors and providing energy. Future research will focus on the causal relationship between obesity and tumors, and develop drugs targeting related targets (such as GPR65, PHD3, Glce) to assist in obesity prevention and control and tumor treatment.

Obesity is not only an important risk factor for the occurrence, progression and metastasis of many types of cancer, but also may affect the tumor immune microenvironment to make the efficacy of tumor immunotherapy more significant, thus inhibiting the tumor, forming the "obesity paradox". Obesity can promote tumorigenesis by altering the levels of leptin and lipocalin, leading to the activation of abnormal signaling pathways and impaired immune cell function, and may also inhibit tumor progression by affecting the tumor immune microenvironment to make the efficacy of tumor immunotherapy more significant, but the specific mechanism is still unclear. This paper reviews the research progress of obesity through multiple mechanisms to remodel the tumor microenvironment, influence immune cell function, and the correlation between obesity and immunotherapy efficacy, aiming to provide a theoretical basis for optimizing tumor immunotherapy strategy.