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.

This study was aimed to evaluate the application of64-slice spiral CT in imaging anatomy of the normal optic canal. The optic canals of 100 healthy subjects were examined by 64-slice spiral CT,and the imaging measurement of the anatomy structures were performed by the multi-planar reconstruction. The longest and the shorzest walls of the optic canal were the medial wall and the inferior wall, respectively.Results indicate that the imaging anatomic measurement of the optic canal can be accurately and easily performed by means of multi-planar reconstruction of 64-slice spiral CT.

ObjectiveTo study the pathological characteristics of intra-acinar pulmonary artery inflammation and its correlation with smoking index and disease progression in smokers with normal lung function and smokers with chronic obstructive pulmonary disease (COPD).MethodsPatients requiting lung resection for peripheral lung cancer were divided into group A (nonsmokers with normal lung function,n = 10), group B (smokers with normal lung function, n = 13), and group C (smokers with stable COPD,n = 10).The lung tissue far away from rumor were resected to compare the pathological changes of intraacinar pulmonary arteries and infiltration level of inflammatory cell in pulmonary non-muscularized arteries (NMA), pulmonary partially muscularized arteries (PMA) and muscularized arteries (MA) among the three groups.The correlation analysis was made among infiltration level, smoking index, percentage of predicted value of forced expiratory volume in one second (FEV,％ Pred), six-minute-walk distance (6MWD) and BODE index.Results (1) Both group B and group C showed the intima and media thickness of MA was significantly higher, the lumen area of MA was narrower and the proportion of MA was higher, and collagenous fiber of MA adventitial proliferated and area increased in group C(P ＜0.05 or P ＜0.01).(2) In group B and group C, the percentage of the intra-acinar pulmonary arteries that contained leukocytes, T lymphocytes, CD8+ T lymphocytes and the number of these positive cells infiltrating the intraacinar pulmonary arteries were increased, especially an increased number of CD8+ T lymphocytes infiltrating in the arterial adventitia as compared with group A, moreover there were significant difference between group C and group B (P ＜ 0.05 or P ＜ 0.01).In group B and group C, the degree of these positive cellsinfiltrating NMA, PMA and MA presented a decreasing sequence (P ＜ 0.05 or P ＜ 0.01).Among the intima, media and adventitia of MA, the infiltration of these positive cells was the highest in the adventitia.Among group A, group B and group C, infiltration degree of CD4+ T lymphocyte, B lymphocyte, macrophage and neutrophil demonstrated no significant difference, also among NMA, PMA and MA (P ＞ 0.05).(3)The number of leukocytes, T lymphocytes, CD8+T lymphocytes infiltrating MA showed a positive correlation with the thickness of MA (r =0.563,0.627,0.589 ,P ＜0.01 ,respectively) and smoking index (r =0.551,0.665, 0.600, P ＜ 0.01, respectively), moreover the degree of these cells infiltrating MA demonstrated negative correlation with FEV1 ％ Pred (r = - 0.763, - 0.703, - 0.767, P ＜ 0.01, respectively).Also infiltrating degree of T lymphocytes and CD8+ T lymphocytes was positively correlated with BODE(r = 0.390,0.476,P ＜ 0.05, respectively). Furthermore the infiltrating degree of CD8+ T lymphocytes had negative correlation with 6MWD (r = - 0.356, P ＜ 0.05).Conclusions(1) Pulmonary arterial inflammation appears in smokers with normal lung function and smokers with COPD patients.It involves in all types of intra-acinar pulmonary arteries especially NMA and infiltrates whole layer of MA with a characteristic of CDs+T lymphocytes infiltrating in the adventitia of intra-acinar pulmonary arteries. (2)Pulmonary inflammation is closely correlated to cigarette smoking and clinical parameters such as BODE index, FEV1％pred and 6MWD.It is one of the key factors affecting the progression of COPD.

Objective To observe the incidence of RP in NSCLC and esophageal carcinoma treated with 3DCRT and investigate the relationship between acute RP and lung function and dosimetric parameters.Methods From October 2006 to August 2008, 3DCRT plus concurrent chemotherapy of NP or LFP were applied to 64 patients with locally advanced NSCLC or esophageal carcinoma. twenty-three patients suffered form NSCLC and 41 patients from esophageal carcinoma, the prescription doses were 60 Gy/30fx and 58 -64 Gy/29 -32fx, respectively. Results For patients with esophageal carcinoma, 34% developed RP(9 grade 1,3 grade 2 and 2 grade 3). For patients with NSCLC, 96% developed RP(9 grade 1, 8 grade 2 and 5 grade 3). There was significant difference between the two groups(t =5. 55,P=0. 000). The FEV1.0/FVC and DLCO of patients with NSCLC were significantly lower than those of esophageal carcinoma, the ratio were 75.6%:82.7%(t=2.75,P=0.008)and 71.7%:81.0%(t=2.50, P=0.015),respectively. For patients whose FEV1.0, FEV1.0/FVC%, DLCO ＜80% and ≥80% before irradiation,the incidence of ≥2grade ARP were 35% vs 25% ,31% vs 26% and 35% vs 19%, respectively(x2 = 1.81,0.15,2. 13,P =0.179,0.697,0.144). While for patients whose FEV1.0 ＜ 70% and ≥70%, the incidence of severe ARP were 67% and 22% ,respectively(x2 =5.64, P =0.018). Spearman correlated analysis indicated that all the dosimetric parameters had relation with ≥ 2 grade ARP . The V20 of lung and MLD were found independently associated with RP according to multivariate analysis(x2 = 4.61,6.97, P = 0.032,0.008).Conclusions Parameters of basic lung function can predict the incidence of ≥2 grade RP to some extent,especially when the value of FEV1.0, FEV1.0/FVC%, and DLCO was lower. However, the V20 of lung and MLD may be the most valuable predictors.

Objective To investigate the value of PET-CT in TNM staging and three-conformal radiotherapy (3DCRT) in esophageal carcinoma. Methods From September 2007 to November 2008, 20 patients with pathologically confirmed esophageal carcinoma were enrolled, including 2 treated with surgery and 18 with 3DCRT. All the patients received PET-CT simulation before the treatment. The length and maximum transverse diameter of Grit based on esophagoscope, esophagography, CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax) were compared. The TNM stages were compared based on CT and PET-CT images. Three treatment plans were produced and analyzed based on images of CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax),respectively. Results The length of lesion on esophagoscope, esophagography, CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax) was 4. 93 cm, 5.06 cm, 6. 67 cm, 5. 89 cm and 4. 84 cm, respectively. The corresponding maximum transverse diameter on the last 3 images was 4. 05 cm, 3.38 cm and 2. 95 cm, respectively. In all, 31, 21 and 14 positive lymph nodes were identified according to CT images, PET-CT images and the both. Five patients with CT diagnosed stage M_0 were found to have distant metastasis by PET-CT images, and 1 patient with CT diagnosed stage M_1 was excluded by PET-CT. The volumes of GTV_(CT) were similar with GTV_(SUV2.5) in 2 patients, smaller in 5 patients, and larger for the remaining 13 patients. For these 13 patients, the radiation dose of normal tissues based on GTV_(SUV2.5) was relatively lower. Conclusions The length of lesion based on PET -CT_(SUV2.5) matches the pathological length best , followed by esophagography. With PET-CT_(40%SUVmax) the actual lesion length may be underestimated. TNM stage might be changed by PET-CT, and then the target volumes and radiation doses of normal tissues might be reduced.

Objective To investigate the result and side effect of late course accelerated three-di-mensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From July 2003 to March 2006, 55 patients with esophageal carcinoma receiving 3DCRT were randomly divided into late course accel-erated radiation group (group A, 27 patients) and conventional fractionation group (group B, 28 patients). The prescribed dose in group B was 64 -66 Gy, 2 Gy per fraction, 1 fraction per day, 5 fractions per week for about 6.5 weeks. Patients in group A received conventional fractionation irradiation for the first 4 weeks. Then the dose was increased to 3 Gy per fraction to a total dose of 67 -70 Gy. The treatment course in group A was about 6 weeks. The treatment response, acute site effects, 1-, 3-and 5-year local control rates and o-verall survival rates of the two groups were observed. Results In group A, 23 patients (85%) achievedcomplete response (CR) and 4(15%) achieved partial response (PR). While in group B, 16 patients (57%) achieved CR and 12(43%) achieved PR. The CR rate was significant higher in group A (χ~2 = 5.24,P=0.022). The 1-, 3-, 5-year local control rates were 85%, 54%, 54% in group A, and 70%, 56%, 33 % in group B (χ~2 = 0.68, P = 0.409), respectively. The 1 -,3-,5-year overall survival rates of the two groups were 81%, 37%, 29% and 61%, 39%, 23% (χ~2 = 0.06, P = O. 804), respectively. Both lo-cal control and overall survival were similar between the two groups. The incidences of acute radiation esoph-agitis in the two groups were similar (85% vs. 89% ;χ~2 =0. 00,P=0. 959), and the incidence of radiation pneumonitis was slightly higher in group A than in group B (67% vs 43% ;χ~2 =3.14,P =0.076). By the last follow up, 19 patients in group A and 21 in group B died. Among them, 10 in group A and 15 in group B died of local failure, while 7 in group A and 5 in group B died of metastasis. Conclusions When com-pared with conventional fractionation 3DCRT, late course accelerated 3DCRT for esophageal carcinoma can achieve better results in clinical response, though not in long-term local control or survival. The incidence of acute radiation esophagitis and pneumonitis is clinically acceptable.

Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.

Objective To observe the incidence of radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) or esophageal carcinoma treated by three-dimensional conformal radiation therapy (3DCRT), and investigate the predictive value of low dose volume of the lung on RP.Methods From Mar 2005 to Aug 2008, 161 patients with locally advanced NSCLC or esophageal carcinoma received 3DCRT. Fifty-three patients with NSCLC received radiotherapy of 60 Gy/30 -34 fx and concurrent chemotherapy of navelbine plus cisplatin (NP). Among the 108 patients with esophageal carcinoma with prescription doses ranging from 58 Gy/29 fx to 70 Gy/35 fx, 46 and 62 received 3DCRT alone or 3DCRT with concurrent chemotherapy of calcium folinate, 5-Fu and cisplatin (LFP), respectively. Univariate and multivariate analysis and receiver operating characteristics (ROC) curves were performed to assess the correlated factors of RP. Results The follow-up rate was 100%. The rate of RP was 57. 8% (93/161) for all patients, 94% (50/53,including 1 with Grade 4 and 1 with Grade 5) for patients with NSCLC, and 39.8% (43/108, none with Grade 4 and 5) for patients with esophageal carcinoma. The correlative factors included the sex, volume of gross tumor volume (GTV), mean lung dose (MLD), V5, V10, V15, V20, V25 and V30 of normal lung according to Spearman correlative analysis. Univariate analysis showed that all the 9 factors could predict RP. Only V5 and the volume of GTV were found independently associated with Grade 2 or more RP in multivariate analysis. ROC analysis indicated that the cut-off point of the curve was 55% with the area under ROC curve of 0. 684 (P = 0. 000). For the patients with lung V5 ≥ 55% and < 55% ,43% (36/84) and 18% (14/77) developed RP of Grade 2 or more, respectively. Conclusions Dosimetric parameters including MLD, normal tissue complication probability, and V5-V30 could predict RP. V5 may be the most valuable predictor. When V5 exceeds 55%, the probability of RP of grade 2 or more may increase notably. Besides the limitation of MLD, V20 and V30, the volume of low dose region should be also limited to a lower range during treatment planning.

The wavelength of infrared rays,beyond that of red visible light in optical spectre,ranges from 0.76 to 1000.00 μm.In clinic,infrared rays include a near-infrared part(with the wavelength ranging from 0.76 to 1.5μm)and a far-infrared part(with the wavelength ranging from 1.5 to 400μm).The far-infrared rays,having a wavelength ranging from 6 to 14 μm,are critical for human health and lives.The far-infrared rays have many biological functions including extending blood capillary,increasing blood flow,enhancing metabolism and repair,accommodating organism disequilibrium,etc.The main biological effect of far-infrared rays is cell activation which can induce a senes of biochemistry and histochemistry changes of calls.With the help of far-infrared rays,human body can be in a healthy status.The main clinical applications of far-infrared rays include auxiliary diagnosis,softening inflammation and pain.tissue repair,sterilization,tumor depression,rewarming from hypothermia,and so on.Far-infrared rays play active functions on human body through caloric effects.Now they are developed to be applied in partial medical fields.The emphases of the future studies are about the effects of far-infrared rays based on molecular biology researches and about the extensive applications of far-infrared rays in medicine.

We cloned genes of four sentrin-specific protease (SENP), three small ubiquitin-like modifiers (SUMO), enhanced cyan fluorescent protein (ECFP) and yellow fluorescent protein (EYFP) by two-step PCR. Then we constructed expression vector B28 for SENP and B13 for ECFP-SUMO-EYFP. The recombinant plasmids were transformed into Escherichia coli BL21 and expression was induced by isopropyl beta-D-thiogalactoside, then recombinant proteins were purified by Ni-NTA agarose column ion-exchange chromatography. The proteins were analyzed with SDS-PAGE and identified with Western blotting. Except that SENP3 catalytic domain (SENP3C) truncated in the C termini and SENP5C expressed in inclusion body, others were expressed as soluble proteins. SDS-PAGE analysis showed that the relative molecular mass of these fusion proteins were consistent with theoretical ones, and the specificity of the fusion proteins were confirmed with Western blotting. The fusion proteins of SENP and ECFP-SUMO-EYFP can be successfully expressed in prokaryotic expression system. It lays the foundation for the fluorescence resonance energy transfer analysis.
Bacterial Proteins ; biosynthesis ; genetics ; Catalytic Domain ; Cysteine Endopeptidases ; biosynthesis ; genetics ; Endopeptidases ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Luminescent Proteins ; biosynthesis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; SUMO-1 Protein ; biosynthesis ; genetics