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 investigate the clinical efficacy of drug eluting stents vs metal bare stents for femoral popliteal arteriosclerosis obliterans.Methods The clinical data of 47 patients with femoral popliteal arte-riosclerosis obliterans receiving endovascular therapy from October 2020 to June 2021 were retrospectively ana-lyzed.A total of 24 cases received drug-eluting stents(DES group)and 23 cases underwent metal bare stents(BMS group).Results All patients successfully completed the operation without any adverse events.There was no statistical difference in ABI between the DES group and the BMS group at 7 days and 3 months after surgery,and ABI growth value of the DES group was higher than that of the BMS group at 6,12 and 24 months after surgery(P<0.05).There was no significant difference in the primary patency rate at 6 months after surgery,However,the primary patency rate in DES group was higher than that in BMS group at 12 and 24 months after surgery(91.7%vs.65.2%,83.3%vs.56.5%,P<0.05).For the target lesion revascularization rate of the two groups,DES group had a significant advantage over BMS group(4.0%vs.26.1%,P<0.05).Conclusion DES had better clinical efficacy and advantage over bare metal stent for the treatment of femoral popliteal arteriosclerosis obliterans.

Objective:To investigate the care needs and influencing factors for caregivers of children with disabilities. Methods:From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. The Care Needs Assessment Tool for Children with Disabilities was used to measure the care needs rates and satisfaction, and multiple linear regression was performed to analyze the related factors. Results:The rate of total need was 71.8%, which was high in the information support (83.7%), spiritual support (75.9%) and financial support (74.1%), and was at an intermediate level in alternative service support (62.9%) and professional support (62.2%). The satisfaction of total need was 39.4%, which was at a intermediate level in the spiritual support (50.8%) and professional support (45.5%), and was at a low level in alternative service support (32.8%), financial support (32.3%) and information support (30.3%). The caregivers needed less support for thoses with higher public policy satisfaction (B = -3.252, 95%CI -5.370 to -1.134, P = 0.003) and the children with vision and speech disability, and undetermined disability (B_{vision disability}= -12.160, 95%CI -21.976 to -2.344, P = 0.015; B_{speech disability}= -12.754, 95%CI -22.583 to -2.925, P = 0.011; B_{undetermined disability}= -16.553, 95%CI -24.714 to -8.392, P < 0.001), while mothers (B = 9.071, 95%CI 4.293 to 13.848, P < 0.001) needed more support than grandparents. The caregivers with higher public policy satisfaction (B = 7.392, 95%CI 5.523 to 9.262, P < 0.001), the children with vision disability, hearing disability and speech disability (B_{vision disability}= 8.612, 95%CI 0.081 to 17.144, P = 0.048; B_{hearing disability}= 8.686, 95%CI 1.920 to 15.451, P=0.012; B_{speech disability}= 9.515, 95%CI 1.184 to 17.846, P = 0.025), lower barriers to social inclusion (B = 1.932, 95%CI 0.457 to 3.408, P = 0.010) and shorter average daily care hours (B = -4.123, 95%CI -6.247 to -1.999, P < 0.001) were more satisfactory for support. Conclusion:The care needs of children with disabilities are diverse, with the highest rate of need for information support and the lowest level of satisfaction. There is some variation in the care needs of children with different types of disabilities, family roles, average daily care hours and social environment characteristics.

Objective:To explore the quality of life of caregivers of children with disabilities and its influencing factors. Methods:From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. The 12-item Short-form Health Survey (SF-12) was used to measure the quality of life of 496 caregivers, and multiple linear regression was performed to analyze the related factors. Results:The score of physical component summary (PCS) of caregivers was (51.67±8.11), and the score of mental component summary (MCS) was (42.10±12.66). The scores of PCS were lower in caregivers with children aged 6 to 18 years (B = -1.783, 95%CI -3.279 to -0.287, P = 0.020), children with emotional instability (B = 2.719, 95%CI 1.254 to 4.184, P < 0.001), female caregivers (B = -3.765, 95%CI -6.578 to -0.953, P = 0.009), and caregivers who were relatively dissatisfied with the policy (B = 1.973, 95%CI 0.367 to 3.578, P = 0.016); and were higher in caregivers with children with speech disabilities (B = 3.463, 95%CI 0.053 to 6.873, P = 0.047). The types of disabilities of children (B_hearing = 9.465, 95%CI 5.107 to 13.823, P < 0.001; B_undetermined = 5.999, 95%CI 1.558 to 10.441, P = 0.008), playmates of children (B = 2.626, 95%CI 0.352 to 4.901, P = 0.024), education level of caregivers (B_{high middle school} = -4.701, 95%CI -8.028 to -1.374, P = 0.006; B_{high school} = -3.610, 95%CI -6.604 to -0.615, P = 0.018), family size (B = 2.616, 95%CI 0.479 to 4.753, P = 0.017) and per capita monthly income (B _{< 5000 Yuan}= -6.572, 95%CI -9.136 to -4.008, P < 0.001; B_{5000 to < 10000 Yuan} = -4.932, 95%CI -7.544 to -2.319, P < 0.001) were associated with the scores of MCS. Conclusion:The quality of life, especially the mental health, of caregivers of children with disabilities is poor. The influencing factors cover multiple dimensions such as caregivers, children, family and social environment.

Objective:To investigate the anxiety state and its influencing factors for caregivers of children with disabilities. Methods:From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. Crosstab was used to analyze the anxiety state and binary logistic regression analysis was used for identifying key factors. Results:There were 73.2% parents and 26.8% grandparents among 496 caregivers. Physical disabilities accounted most (26.0%) in the children. About 35.1% caregivers reported their anxiety state, and more than 10% reported moderate to severe anxiety. The results of logistic regression analysis showed that grandfather reported 0.318 times anxiety to mother (OR = 0.318, 95%CI 0.113 to 0.900, P = 0.031). Sleep problems (OR = 1.713, 95%CI 1.046 to 2.805, P = 0.032) and emotional functioning (OR_generally = 0.057, 95%CI 0.009 to 0.340, P = 0.002; OR_stable = 0.031, 95%CI 0.005 to 0.205, P < 0.001) of children were associated with the rate of caregiver-reported anxiety. Among family environment factors, monthly per capita household income (OR_{5000-< 10000 Yuan} = 0.463, 95%CI 0.236 to 0.909, P = 0.025; OR_{≥ 10,000 Yuan} = 0.325, 95%CI 0.160 to 0.660, P = 0.002) and housing status (OR = 0.356, 95%CI 0.208 to 0.608, P < 0.001) were associated with the rate of caregiver-reported anxiety. Among social environment factors, caregivers who were satisfied with current accessibility reported lower rate of anxiety (OR_satisfied = 0.136, 95%CI 0.031 to 0.602, P = 0.009). Conclusion:The anxiety state of caregivers of children with disabilities is higher than that of the general population. When caregivers are caring for a child with sleep problem or emotional issue, have low household income, or dissatisfied with the barrier-free environment, they may face higher risk of anxiety.

OBJECTIVETo evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy.

METHODSA total of 105 patients received the operation with age ranging from 51 to 73 years from January 2008 to June 2010. Mean level of serum prostate specific antigen was 13.6 µg/L and mean prostatic volume was 45 ml. Pathological studies of biopsy confirmed the prostate carcinoma with Gleason score 6-8. Radionuclide bone scan revealed no metastasis. Based on previously retroperitoneal radical prostatectomy, modified technique was applied involving surgical approach, bladder neck dissection and vesicourethral anastomosis.

RESULTSMean operative time was 93 min (65 - 150 min). Intraoperative blood loss was 115 ml (50 - 400 ml). No complication of bowl injury occurred. Positive surgical margin was present in 24 patients. Normal continence were seen in 64 patients after catheter removed. Recovery of incontinence within 3 months was seen in 33 patients and 3 to 12 months in 5 patients respectively. Three patients with incontinence were still in the follow-up.

CONCLUSIONSTransperitoneal laparoscopic radical prostatectomy provides large working space and clear anatomic exposure. Higher efficiency and lower complication rate are obtained through modified laparoscopic technique involving seminal vesicle isolation, bladder neck dissection and vesicourethral anastomosis.

Abdominal Cavity ; surgery ; Aged ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Retrospective Studies

BACKGROUNDAlthough chemotherapy is one of the most important treatments of breast cancer, it is limited by significant inter-individual variations in response and toxicity. The metabolism of epirubicin (EPI) and cyclophosphamide (CTX) is mainly mediated by cytochrome P450s (CYPs) and glutathione S-transferases (GSTs). It has been well-known that the activities of these enzymes are polymorphic in population due to their genetic polymorphisms. The aim of this research was to examine the effects of genetic polymorphisms in CYP3A, GSTP1 and MDR1 genes on treatment response and side-effects of breast cancer patients receiving EPI/CTX chemotherapy.

METHODSOne hundred and twenty patients with stage II or III invasive breast cancer were recruited and treated with three to four cycles of EPI 80 mg/m(2) and CTX 600 mg/m(2) every two weeks. The AJCC TNM staging system (sixth edition) was used to evaluate the pathological response of primary tumor and axillary lymph nodes. The genotypes of gene polymorphisms were determined by using PCR-restriction fragment length polymorphism methods.

RESULTSPatients carrying GSTP1 (105)Ile/Val or (105)Ile/Ile genotype were more likely to have good response (OR, 0.40; 95%CI, 0.16 - 0.96; P = 0.024) and light toxicity (OR, 0.35; 95%CI, 0.13 - 0.78; P = 0.006) than those carrying (105)Val/Val genotypes. The response to the treatment was not correlated with estrogen receptor, progesterone receptor and Her2/neu status of tumors. No correlation was found between toxicity effect and patient's age, tumor staging, menopause status, and dose intensity of the drugs.

CONCLUSIONGSTP1 polymorphism was associated with the chemotherapy response or adverse effects of EPI and CTX regimens.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; drug therapy ; genetics ; Cyclophosphamide ; therapeutic use ; Epirubicin ; therapeutic use ; Female ; Genotype ; Glutathione S-Transferase pi ; genetics ; Humans ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; genetics

This study is to investigate the influence and mechanism of action of asymmetrical dimethylarginine (ADMA) and the induced oxidative stress level on Alzheimer's disease (AD) incidence. ADMA concentration, nitric oxide, Abeta(40)/Abeta(42) ratio, inducible NO synthase (iNOS) activity and the concentrations of the induced free radicals including malondialdehyde (MDA), 3-nitrotyrosine (3-NT) and peroxynitrite (ONOO-) in the cerebrospinal fluid (CSF) from 34 neurologically normal controls and 37 AD patients were quantitatively determined and statistically compared. The results showed that the ADMA concentration significantly decreased in AD patients, and it showed negative correlation with the NO, iNOS activity, and showed positive correlation with MMSE score. ADMA concentration was negatively correlated with Abeta(40)/Abeta(42) ratio (P<0.01) with the observation that Abeta(40)/Abeta(42) ratio increased while ADMA level decreased in CSF in AD patients. The concentration levels of MDA, 3-NT and ROS significantly increased compared with the control with all the P values less than 0.05. These findings suggested that the ADMA disorder and the oxidative damage effect of the induced free radicals in CSF of AD patients are an important mechanism of AD incidence, and their joint regulation may provide new idea for the prevention and clinical treatment of AD.
Aged ; Alzheimer Disease ; cerebrospinal fluid ; Amyloid beta-Peptides ; cerebrospinal fluid ; Arginine ; analogs & derivatives ; cerebrospinal fluid ; Female ; Humans ; Male ; Malondialdehyde ; cerebrospinal fluid ; Middle Aged ; Nitric Oxide ; cerebrospinal fluid ; Nitric Oxide Synthase Type II ; cerebrospinal fluid ; Oxidative Stress ; Peptide Fragments ; cerebrospinal fluid ; Peroxynitrous Acid ; cerebrospinal fluid ; Reactive Oxygen Species ; cerebrospinal fluid ; Tyrosine ; analogs & derivatives ; cerebrospinal fluid

OBJECTIVETo compare the effect between lumbar backwards flexion manipulation and rotating manipulation for treating lumbar intervertebral disc herniation.

METHODSTwo hundred and nine patients of lumbar intervertebral disc herniation, male 131, female 78, the age from 20 to 79 years old, 58 cases of all these patients age above 50. According to diagnosis the ladder of the 92 cases bulging type, 69 hernia type, 48 cases free type. The patients were randomly divided into treatment group (107 cases) and control group (102 cases). All the patients were treated with the three-dimensional computer-controlled traction therapeutic apparatus, with continued traction for 30 minutes. After traction, lumbar backwards flexion manipulation and rotating manipulation were respectively adopted in treatment group and control group (on alternate days one time, 3 times as a course of treatment). The symptoms and signs (including back pain and discomfort, lower limb pain and numbness, powerless urination and defecation, numbness in perineum, straight-leg raising degree, ability of lower extremity walking, work and live) of patients were observed after treatment.

RESULTSAll the patients were followed up from 1 to 6 months with an average of 3.2 months. After treatment, the symptoms and signs of patients have markedly improved (P < 0.01), but the lower back pain and discomfort, lower limb walking ability in treatment group were better than control group (P < 0.05). According therapeutic criteria, the effect of treatment group was better than of control group (P < 0.01). In cases with bulging type, 47 in treatment group and 45 in control group, the effect of treatment group was better than of control group (P < 0.05); in cases with hernia type, 35 in treatment group and 34 in control group, there was no significantly difference in effect between two groups (P > 0.05); in cases of free type, 25 in treatment group and 23 in control group, there was no significantly difference in effect between two groups (P > 0.05).

CONCLUSIONThe global effect of lumbar backwards flexion manipulation was satisfactory than rotating manipulation for treating lumbar intervertebral disc herniation. But rotating manipulation suited to free type.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; therapy ; Lumbar Vertebrae ; pathology ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Treatment Outcome

OBJECTIVETo investigate the influence of lipopolysaccharide (LPS) on macrophages expressing TNF-alpha related apoptosis induced-ligand (TRAIL) and its relation to apoptosis of HepG2 cell line.

METHODSMembrane-bound TRAIL (mTRAIL) was measured by flow cytometry; soluble TRAIL in supernatant was detected by enzyme-linked immunoabsorbent sandwich assay (ELISA); cytotoxicity of TRAIL to HepG2 cell line was measured by chromium release assay, and apoptosis of HepG2 cell was confirmed by Annexin V staining.

RESULTSLPS only slightly increased membrane-bound TRAIL expression of macrophages. On the other hand, soluble TRAIL in the supernatant was increased with LPS stimulation, and the optimal concentration of LPS was 100 ng/ml (sTRAIL value 67.40 ng/ml+/-5.08 ng/ml). The soluble TRAIL in the supernatant was cytotoxic to HepG2 cells, and this activity can be blocked by TRAIL neutralizing antibodies.

CONCLUSIONLPS increases the expression of soluble TRAIL in macrophages, and soluble TRAIL is toxic to HepG2 cells. All of our results indicate that TRAIL may play an important role in the pathogenesis of viral hepatitis.

Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; pathology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lipopolysaccharides ; pharmacology ; Liver Neoplasms ; pathology ; Macrophages ; metabolism ; TNF-Related Apoptosis-Inducing Ligand ; biosynthesis ; genetics ; pharmacology ; Tumor Cells, Cultured