Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.

[摘 要] 目的：探讨异莲心碱（Iso）通过PI3K/Akt/mTOR信号通路对结肠癌SW480细胞增殖、凋亡和自噬的影响。方法：用10、20和40 μmol/L的Iso处理结肠癌SW480细胞，CCK-8法、流式细胞术和WB法分别检测Iso对细胞增殖活力、凋亡和自噬相关蛋白LC3Ⅰ、LC3Ⅱ、p62表达的影响。然后，用20 μmol/L的Iso和25 μmol/L的PI3K激活剂740 Y-P分别处理SW480细胞，将细胞分为对照组、740 Y-P组、Iso组和Iso+740 Y-P组，流式细胞术、WB法检测Iso和740 Y-P对各组细胞凋亡及细胞中LC3Ⅰ、LC3Ⅱ、p62、PI3K、p-PI3K、 mTOR和p-mTOR蛋白表达的影响。结果：10、20和40 μmol/L的Iso处理后，SW480细胞增殖活力均显著下降（均P<0.05），细胞凋亡率均显著升高（均P<0.05），LC3Ⅱ/LC3Ⅰ表达均显著上调（均P<0.05），p26蛋白表达显著下调（P<0.05）。Iso和740 Y-P处理后，与对照组相比，740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达均显著下降（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著升高（均P<0.05）；Iso组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达升高（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著下降（均P<0.05）；与740 Y-P组相比，Iso+740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达升高（P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著下降（均P<0.05）；与Iso组相比，Iso+740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达下降（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著升高（均P<0.05）。结论：Iso通过抑制PI3K/Akt/mTOR信号通路抑制结肠癌SW480细胞增殖并诱导细胞凋亡和自噬。

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective:To evaluate the efficacy of ultrasound-guided core needle biopsy(US-CNB)in the diagnosis of oral and max-illofacial tumors.Methods:The clinical records,radiology and histopathology reports along with the biopsy of 192 patients with oral and maxillofacial tumors who received US-CNB were retrospectively reviewed and stastactivelly analyized.Results:The overall sensi-tivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy of US-CNB for the diagnosis of oral and maxillofacial tumors were 93.1％,100％,100％,94.6％and 96.9％,respectively.The misdiagnosis ratio was 3.1％.Kappa value was 0.937(95％CI:0.887～0.986).The AUC of ROC for the diagnosis was 0.966(95％CI:0.929～0.986).Conclusion:US-CNB is an accurate and efficient method for the histological diagnosis of oral and maxillofacial tumors,and can be considered as the first-line diagnostic modality.

Objectives:To investigate the value of metagenomic next-generation sequencing (mNGS) in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:The data of 98 patients with suspected pulmonary infection after allo-HSCT who underwent pathogen detection from bronchoalveolar lavage fluid between June 2016 and August 2023 at Nanfang Hospital were analyzed. The diagnostic performance of mNGS, conventional methods, and real-time quantitative polymerase chain reaction (qPCR) for PJP were compared.Results:A total of 12 patients were diagnosed with PJP, including 11 with a proven diagnosis and 1 with a probable diagnosis. Among the patients with a proven diagnosis, 1 was positive by both conventional methods and qPCR, and 10 were positive by qPCR only. Pneumocystis jirovecii was detected by mNGS in all 12 patients. The diagnostic sensitivity of mNGS for PJP was 100%, which was greater than that of conventional methods (8.3%, P=0.001) and similar to that of qPCR (91.6%, P=1.000) . A total of 75% of the patients developed mixed pulmonary infections, and cytomegalovirus and Epstein-Barr virus were the most common pathogens. Mixed infection was detected in eight patients by mNGS and in five patients by qPCR, but not by conventional methods ( P=0.008) . Conclusions:mNGS had good sensitivity for diagnosing PJP after allo-HSCT and was advantageous for detecting mixed infectious pathogens; therefore, mNGS might be an effective supplement to regular detection methods and qPCR.

Objective:To observe the multi-modal fundus imaging features of subretinal drusenoid deposit (SDD) in age-related macular degeneration (AMD), and observe image features.Methods:A prospective clinical study. From December 2019 to December 2023, 65 patients (104 eyes) with a diagnosis of AMD-SDD by spectral domain optical coherence tomography (SD-OCT) examination in Shandong Eye Hospital were included. All eyes were examined by best corrected visual acuity (BCVA), traditional color fundus photography (CFP), ultra-wide-angle scanning laser fundus imaging (UWF), multicolor scanning laser fundus imaging (MC) and SD-OCT. The standard MC images were obtained by using Spectralis HRA+OCT for MC examination. The multi-mode image characteristics of SDD were analyzed retrospectively. Area under curve (AUC) was used to evaluate the sensitivity and specificity of CFP, MC and UWF in detecting SDD.Results:Among 65 patients with SDD, 29 cases of males (52 eyes) and 36 cases of females (52 eyes) was included. There were 26 patients with unilateral SDD and 39 patients with bilateral SDD. The average age was (71.74±10.97) years. The early, middle and late stages of AMD were 31 (29.8%, 31/104), 24 (23.1%, 24/104), 49 (47.1%, 49/104) eyes, respectively. The SDD detected by CFP, MC and UWF was 76 (73.1%, 76/104), 94 (90.4%, 94/104), 96 (92.3%, 96/104) eyes. CFP showed that the edge of SDD in the macular area was blurred. UWF showed that the dot and the ribbon SDD were light yellow pale discrete deposits and light yellow interlaced network deposits respectively. MC showed the dot SDD had a strong yellow-green circular reflection, while the edge of the ribbon SDD was surrounded by a weak reflection, and the boundary was clear. SD-OCT showed that SDD had strong reflection signal, which was located between the retinal pigment epithelium layer and the photoreceptor cell layer. The dot SDD could break through the ellipsoid zone and caused slight uplift or interruption of the external membrane, showing a cone-like strong reflection signal. While the ribbon SDD showed a continuous "hill-like" protrusion, which hardly broke through ellipsoid zone. The sensitivity and specificity of CFP, MC and UWF for SDD were 73.1%, 90.4%, 92.3% and 61.1%, 94.4% and 83.3%, respectively.Conclusions:MC and UWF show high sensitivity and specificity in diagnosing AMD-SDD, which is superior to CFP. SD-OCT can effectively reveal the location and morphoLogical characteristics of SDD under retina.

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Objective    To investigate the perioperative efficacy and safety of all-port robotic lobectomy versus thoracoscopic lobectomy in stageⅠA non-small cell lung cancer. Methods    The clinical data of patients with stageⅠA non-small cell lung cancer who underwent lobectomy with lymph node dissection performed by the same operator in our center from June 2019 to June 2022 were retrospectively analyzed. The patients were divided into a robotic group and a thoracoscopic group according to different procedures. We compared the relevant indexes such as operation time, intraoperative bleeding, number of lymph node dissection stations, number of lymph node dissection, postoperative tube time, postoperative hospitalization time, closed chest drainage volume, postoperative pain, postoperative complications and hospitalization cost between the two groups. Results    There were 83 patients in the robotic group, including 34 males and 49 females with a median age of 60.0 (53.0, 67.0) years, and 94 patients in the thoracoscopic group, including 36 males and 58 females with a median age of 60.5 (54.0, 65.3) years. There was no conversion to thoractomy or death in postoperative 90 days in both groups. No statistical difference was seen in the operation time, total postoperative drainage volume and postoperative complication rates between the two groups (P>0.05). Patients in the robotic group had less intraoperative bleeding (P<0.001), more lymph node dissection stations (P=0.002) and numbers (P=0.005), less postoperative pain (P=0.002), and shorter postoperative time with tubes (P=0.031) and hospital stay (P<0.001). However, the surgery was more expensive in the robotic group (P<0.001). Conclusion    All-port robotic surgery is safe and effective for patients with early-stage non-small cell lung cancer with less intraoperative bleeding, more lymph node dissection, less postoperative pain, and shorter hospital stay compared with the thoracoscopic surgery.

Objective To investigate the predictive value of preoperative bi-parametric MRI radiomics for the International Society of Urological Pathology(ISUP)grading of prostate cancer(PCa).Methods One hundred and sixty-five patients with PCa confirmed by pathology were analyzed retrospectively.According to the ISUP grading system,PCa patients were divided into five subgroups:G1 group(Gleason score=6),G2 group(Gleason score=3+4),G3 group(Gleason score=4+3),G4 group(Gleason score=8)and G5 group(Gleason score=9 or 10).A total of 3 948 radiomics features were extracted from T2WI,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC)images of each patient.Patients were classified into two categories based on Gleason score≥4+3 or ≤3+4.A radiomics signature(Rad-score)was constructed after reduction of dimension by the minimum redundancy maximum relevance(mRMR)and the least absolute shrinkage and selection operator(LASSO).The Spearman rank correlation test was used to evaluate the correlation between Rad-score and ISUP grading groups.The Kruskal-Wallis test was used to compare the difference of Rad-score among the five groups.Results Eleven most valuable features were selected as the Rad-score after reducing the dimension by mRMR and LASSO algorithm.Moderate correlation existed between Rad-score and ISUP grading(r=0.53,P＜0.05).There were significant differences in Rad-score between G1 and G2 groups and G3,G4 and G5 groups(P＜0.05),no significant difference existed between the remained two groups(P＞0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curve for Rad-score were 0.827,0.762,0.563,0.657,0.698 for G1,G2,G3,G4 and G5 groups,respectively.Conclusion The radiomics based on bi-parametric MRI can be used to predict grade 1,2 PCa patients in the ISUP grading system.