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.

Objective:To explore the differences in the standardized z-score amplitude of low-frequency fluctuations (zALFFs) across different brain regions between children with global developmental delay (GDD) and healthy children (HC) using functional near-infrared spectroscopy (fNIRS), and correlating zALFF values with the subjects′ Gesell Developmental Scale (GDS) scores.Methods:Thirty-one children aged 2-4 years with GDD and 29 HC of the same age were studied. fNIRS was used to record both groups′ brain activity in response to natural stimuli and to measure any changes in oxygenated hemoglobin (HbO) levels in cerebral blood flow. zALFF values were calculated and the values of 44 channels were compared between the two groups. The correlations between zALFF values and GDS scores were computed.Results:The zALFF values of the children with GDD were significantly lower than those of the HC in the right frontal pole (channel 10) and the right pre-motor and supplementary motor areas (channel 43). In contrast, the zALFF values in the left pre-motor and supplementary motor areas (channels 24 and 26) were significantly higher in the children with GDD compared to the HC. Spearman ranked correlation analysis revealed that the zALFF values in the right pre-motor and supplementary motor areas (channel 43) were positively correlated with socialization scores on the GDS ( r=0.37, P≤0.05). Conclusions:The delays in cognitive and motor development in children with GDD may be associated with functional abnormalities in the right frontal polar region and the bilateral premotor and supplementary motor areas. zALFF values from the right premotor and supplementary motor areas are positively correlated with social skills.

Objective Using meta-analysis to identify the risk factors for slow-flow or no-reflow during percutaneous coronary intervention(PCI)in patients with ST-segment elevation acute myocardial infarction(AMI).Methods A computerized retrieval of academic papers concerning the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI from the databases of CNKI,Wanfang Database,VIP,SinoMed,PubMed,Web of Science,Embase,and Cochrane Library was conducted.The retrieval time period was from the establishment of the database to January 2024.In order to ensure the accuracy and reliability of the study,two independent reviewers screened the literature according to the preset inclusion and exclusion criteria,extracted key data,and strictly evaluated the quality of the literature.RevMan5.4 software was used to make meta-analysis.Results A total of 23 articles with a total of 9 780 cases were included in this analysis.The results of meta-analysis showed that reperfusion time ≥6 h(OR=1.52),preoperative TIMI blood flow≤level-Ⅰ(OR=1.12),heavy thrombus burden(OR=1.60),advanced age(OR=1.56),diabetes(OR=1.83),preoperative Killip grade≥Ⅲ(OR=2.52),long target vessel disease(OR=1.95),and collateral flow≤level-Ⅰ(OR=1.61)were the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.Preoperative systolic blood pressure＜90 mmHg(OR=1.17)and high white blood cell(WBC)count(OR=1.27)were not the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.Conclusion Reperfusion time ≥ 6 h,preoperative TIMI blood flow≤level-Ⅰ,heavy thrombus burden,advanced age,diabetes,preoperative Killip grade≥level-Ⅲ,long target vessel lesion,and collateral blood flow≤level-Ⅰ are the independent risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.

Objective:To investigate whether intermittent fasting alleviates insulin resistance in a polycystic ovary syndrome(PCOS) mouse model through the regulation of autophagy.Methods:Fifty 3-week-old female C57BL/6J mice were randomly assigned into the following groups using a random number table: normal control(NC) group( n=10), maintained on a standard chow diet; high-fat diet(HFD) group( n=10) fed a diet with 60% of calories derived from fat; and PCOS model group( n=30), established by combining a HFD with dehydroepiandrosterone(DHEA) administration. Successful modeling was confirmed by disrupted estrous cycles, hyperandrogenism, and polycystic ovarian morphology. The PCOS model mice were further divided into three groups: PCOS group( n=9), PCOS with intermittent fasting group(PCOS+ IF, n=9), and PCOS with intermittent fasting plus the autophagy inhibitor 3-methyladenine(3-MA) group(PCOS+ IF+ 3-MA, n=9). Autophagy levels were assessed by detecting markers LC3 and p62 and observing autophagosomes via transmission electron microscopy. Glucose tolerance test(GTT) and insulin tolerance test(ITT) were performed, and the area under the curve(AUC) was calculated to evaluate insulin resistance. Western blotting was used to detect phosphorylation levels of phosphatidylinositol 3-kinase(PI3K), protein kinase B(Akt), mammalian target of rapamycin(mTOR), and p70S6 kiase(p70S6K). Results:Compared with the NC group, the PCOS model group showed absent estrous cycles, significantly elevated serum testosterone, sex hormone binding globulin, and luteinizing hormone(LH) levels( P<0.001), and polycystic ovarian changes on hematoxylin-eosin staining, confirming successful model establishment. Immunohistochemistry, transmission electron microscopy, and Western blotting demonstrated that autophagy levels were increased in the PCOS+ IF group compared with the PCOS group, while 3-MA administration reduced the intermittent fasting - induced autophagy. The AUC values for both GTT and ITT were significantly lower in the PCOS+ IF group than those in the PCOS group( P<0.001, P=0.003), but increased in the PCOS+ IF+ 3-MA group compared to the PCOS+ IF group( P<0.001, P=0.020). Western blotting analysis showed that phosphorylation levels of PI3K, Akt, mTOR, and p70S6K were significantly decreased in the PCOS+ IF group compared with the PCOS group( P=0.002, P=0.001, P=0.001, and P<0.001, respectively), and increased in the PCOS+ IF+ 3-MA group compared with the PCOS+ IF group( P=0.021, P=0.041, P=0.047, and P=0.024, respectively). Conclusions:Intermittent fasting alleviates insulin resistance in a PCOS mouse model through inhibitiing PI3K/Akt/mTOR signaling pathway and promoting autophagy.

Objective:To investigate the diagnostic value of multi-slice computed tomography (MSCT) combined with serum interleukin-34 (IL-34) and monocyte chemoattractant protein-1 (MCP-1) detection for active pulmonary tuberculosis.Methods:The clinical data of 80 patients with pulmonary tuberculosis admitted to Yulin Third Hospital from March 2021 to March 2024 who underwent MSCT examination and IL-34 and MCP-1 detection, were retrospectively analyzed. The patients were divided into an active pulmonary tuberculosis group ( n = 44) and an inactive pulmonary tuberculosis group ( n = 36) based on the results of the etiological examination. The differences in MSCT signs, IL-34 and MCP-1 levels were compared between the two groups. The accuracy, sensitivity, specificity, and consistency of MSCT combined with serum IL-34 and MCP-1 detection in the diagnosis of active pulmonary tuberculosis were evaluated taking the etiological examination as the gold standard. Receiver operating characteristic curves were used to analyze the diagnostic efficacy of MSCT combined with serum IL-34 and MCP-1 detection for active pulmonary tuberculosis. Results:In the active pulmonary tuberculosis group, the prevalences of the tree bud sign [63.16% (27/44)], ground-glass opacities [52.27% (23/44)], lung consolidation [45.45% (20/44)], and cavities [68.18% (30/44)] were significantly higher than those in the inactive pulmonary tuberculosis group [36.11% (13/36), 25.00% (9/36), 13.89% (5/36), 44.44% (16/36); χ2 = 5.05, 6.14, 9.18, 4.57, all P < 0.05]. The levels of IL-34 [(2 074.48 ± 338.81) ng/L] and MCP-1 [(315.89 ± 91.89) ng/L] in the active pulmonary tuberculosis group were significantly higher than those in the inactive pulmonary tuberculosis group [(1 655.56 ± 232.37) ng/L, (260.73 ± 123.73) ng/L, t = 6.54, 2.22, both P < 0.05]. Using the etiological results as the gold standard, the accuracy of MSCT in diagnosing active pulmonary tuberculosis was 87.50%, with a sensitivity of 86.36% and specificity of 88.89%. The Kappa value was 0.749, indicating good consistency. Receiver operating characteristic curve analysis showed that the area under the curve for MSCT, IL-34, and MCP-1, both alone and in combination, in diagnosing active pulmonary tuberculosis was 0.876, 0.835, 0.631, and 0.950, respectively. When using cutoff values, the sensitivity for MSCT, IL-34, and MCP-1, both alone and in combination, was 0.889, 0.750, 0.932, 0.609, and 0.944, respectively, while the specificity was 0.864, 0.861, 0.689, and 0.886, respectively. Conclusions:The results of MSCT are consistent with those of pathogen examination. MCP-1 has diagnostic value for active pulmonary tuberculosis. MSCT, IL-34, and the combination of MSCT, IL-34, and MCP-1 demonstrate a high diagnostic value for active pulmonary tuberculosis. The combination of MSCT, IL-34, and MCP-1 offers a new non-invasive diagnostic method for clinical practice, which holds great scientific importance and clinical application value.

Objective:To investigate the diagnostic value of multi-slice computed tomography (MSCT) combined with serum interleukin-34 (IL-34) and monocyte chemoattractant protein-1 (MCP-1) detection for active pulmonary tuberculosis.Methods:The clinical data of 80 patients with pulmonary tuberculosis admitted to Yulin Third Hospital from March 2021 to March 2024 who underwent MSCT examination and IL-34 and MCP-1 detection, were retrospectively analyzed. The patients were divided into an active pulmonary tuberculosis group ( n = 44) and an inactive pulmonary tuberculosis group ( n = 36) based on the results of the etiological examination. The differences in MSCT signs, IL-34 and MCP-1 levels were compared between the two groups. The accuracy, sensitivity, specificity, and consistency of MSCT combined with serum IL-34 and MCP-1 detection in the diagnosis of active pulmonary tuberculosis were evaluated taking the etiological examination as the gold standard. Receiver operating characteristic curves were used to analyze the diagnostic efficacy of MSCT combined with serum IL-34 and MCP-1 detection for active pulmonary tuberculosis. Results:In the active pulmonary tuberculosis group, the prevalences of the tree bud sign [63.16% (27/44)], ground-glass opacities [52.27% (23/44)], lung consolidation [45.45% (20/44)], and cavities [68.18% (30/44)] were significantly higher than those in the inactive pulmonary tuberculosis group [36.11% (13/36), 25.00% (9/36), 13.89% (5/36), 44.44% (16/36); χ2 = 5.05, 6.14, 9.18, 4.57, all P < 0.05]. The levels of IL-34 [(2 074.48 ± 338.81) ng/L] and MCP-1 [(315.89 ± 91.89) ng/L] in the active pulmonary tuberculosis group were significantly higher than those in the inactive pulmonary tuberculosis group [(1 655.56 ± 232.37) ng/L, (260.73 ± 123.73) ng/L, t = 6.54, 2.22, both P < 0.05]. Using the etiological results as the gold standard, the accuracy of MSCT in diagnosing active pulmonary tuberculosis was 87.50%, with a sensitivity of 86.36% and specificity of 88.89%. The Kappa value was 0.749, indicating good consistency. Receiver operating characteristic curve analysis showed that the area under the curve for MSCT, IL-34, and MCP-1, both alone and in combination, in diagnosing active pulmonary tuberculosis was 0.876, 0.835, 0.631, and 0.950, respectively. When using cutoff values, the sensitivity for MSCT, IL-34, and MCP-1, both alone and in combination, was 0.889, 0.750, 0.932, 0.609, and 0.944, respectively, while the specificity was 0.864, 0.861, 0.689, and 0.886, respectively. Conclusions:The results of MSCT are consistent with those of pathogen examination. MCP-1 has diagnostic value for active pulmonary tuberculosis. MSCT, IL-34, and the combination of MSCT, IL-34, and MCP-1 demonstrate a high diagnostic value for active pulmonary tuberculosis. The combination of MSCT, IL-34, and MCP-1 offers a new non-invasive diagnostic method for clinical practice, which holds great scientific importance and clinical application value.

Objective:To explore the differences in the standardized z-score amplitude of low-frequency fluctuations (zALFFs) across different brain regions between children with global developmental delay (GDD) and healthy children (HC) using functional near-infrared spectroscopy (fNIRS), and correlating zALFF values with the subjects′ Gesell Developmental Scale (GDS) scores.Methods:Thirty-one children aged 2-4 years with GDD and 29 HC of the same age were studied. fNIRS was used to record both groups′ brain activity in response to natural stimuli and to measure any changes in oxygenated hemoglobin (HbO) levels in cerebral blood flow. zALFF values were calculated and the values of 44 channels were compared between the two groups. The correlations between zALFF values and GDS scores were computed.Results:The zALFF values of the children with GDD were significantly lower than those of the HC in the right frontal pole (channel 10) and the right pre-motor and supplementary motor areas (channel 43). In contrast, the zALFF values in the left pre-motor and supplementary motor areas (channels 24 and 26) were significantly higher in the children with GDD compared to the HC. Spearman ranked correlation analysis revealed that the zALFF values in the right pre-motor and supplementary motor areas (channel 43) were positively correlated with socialization scores on the GDS ( r=0.37, P≤0.05). Conclusions:The delays in cognitive and motor development in children with GDD may be associated with functional abnormalities in the right frontal polar region and the bilateral premotor and supplementary motor areas. zALFF values from the right premotor and supplementary motor areas are positively correlated with social skills.

Objective:To investigate whether intermittent fasting alleviates insulin resistance in a polycystic ovary syndrome(PCOS) mouse model through the regulation of autophagy.Methods:Fifty 3-week-old female C57BL/6J mice were randomly assigned into the following groups using a random number table: normal control(NC) group( n=10), maintained on a standard chow diet; high-fat diet(HFD) group( n=10) fed a diet with 60% of calories derived from fat; and PCOS model group( n=30), established by combining a HFD with dehydroepiandrosterone(DHEA) administration. Successful modeling was confirmed by disrupted estrous cycles, hyperandrogenism, and polycystic ovarian morphology. The PCOS model mice were further divided into three groups: PCOS group( n=9), PCOS with intermittent fasting group(PCOS+ IF, n=9), and PCOS with intermittent fasting plus the autophagy inhibitor 3-methyladenine(3-MA) group(PCOS+ IF+ 3-MA, n=9). Autophagy levels were assessed by detecting markers LC3 and p62 and observing autophagosomes via transmission electron microscopy. Glucose tolerance test(GTT) and insulin tolerance test(ITT) were performed, and the area under the curve(AUC) was calculated to evaluate insulin resistance. Western blotting was used to detect phosphorylation levels of phosphatidylinositol 3-kinase(PI3K), protein kinase B(Akt), mammalian target of rapamycin(mTOR), and p70S6 kiase(p70S6K). Results:Compared with the NC group, the PCOS model group showed absent estrous cycles, significantly elevated serum testosterone, sex hormone binding globulin, and luteinizing hormone(LH) levels( P<0.001), and polycystic ovarian changes on hematoxylin-eosin staining, confirming successful model establishment. Immunohistochemistry, transmission electron microscopy, and Western blotting demonstrated that autophagy levels were increased in the PCOS+ IF group compared with the PCOS group, while 3-MA administration reduced the intermittent fasting - induced autophagy. The AUC values for both GTT and ITT were significantly lower in the PCOS+ IF group than those in the PCOS group( P<0.001, P=0.003), but increased in the PCOS+ IF+ 3-MA group compared to the PCOS+ IF group( P<0.001, P=0.020). Western blotting analysis showed that phosphorylation levels of PI3K, Akt, mTOR, and p70S6K were significantly decreased in the PCOS+ IF group compared with the PCOS group( P=0.002, P=0.001, P=0.001, and P<0.001, respectively), and increased in the PCOS+ IF+ 3-MA group compared with the PCOS+ IF group( P=0.021, P=0.041, P=0.047, and P=0.024, respectively). Conclusions:Intermittent fasting alleviates insulin resistance in a PCOS mouse model through inhibitiing PI3K/Akt/mTOR signaling pathway and promoting autophagy.

Objective: Based on 3D printing technology, explore the precision of a perforator vessel location guide plate for fibular musculocutaneous flaps before the transplantation of fibular osteocutaneous flaps and evaluate its application effects. Methods: This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. From May 2019 to October 2022, 14 patients with jaw defects who needed to undergo fibular perforator flap transplantation at the First Affiliated Hospital of Xinjiang Medical University were selected. For the seven patients in the guide plate group, CTA was combined with Mimics software to reconstruct both lower limbs, and the perforator vessel positioning guide for locating perforator vessels was designed; the two ends of the guide plate were designed as fixed ends, with the upper end fixed to the knee joint and the lower end fixed to the ankle joint, and the guide plate was fabricated by a 3D printer. For the seven patients in the control group, a conventional handheld Doppler probe was used for perforator vessel location. The average operation time, bleeding volume, recovery time, deviation of perforator vessel location, postoperative flap-related complications, postoperative donor site shape satisfaction, and lower extremity functional scale (LEFS) score were recorded. SPSS 25.0 software was used for statistical analysis. Results: The average operation time, bleeding volume, recovery time, deviation of perforator vessel location and postoperative donor site shape satisfaction were significantly better in the guide plate group than in the control group (P<0.05); moreover, the differences in postoperative flap-related complications and LEFS scores were not statistically significant (P>0.05). Conclusion Based on 3D printing technology, fibular musculocutaneous flap perforator vessels can be more accurately located using a guide plate and the knee and ankle as fixed points, and this method can effectively stabilize the guide position, prevent soft tissue offset, and improve positioning accuracy and thus deserves to be generalized.