Social Work Intervention of Stranded Patients from the Ecosystem Perspective: Based on the Clinical Case Record Analysis of Social Work Department in Shanghai D Hospital / 中国医学伦理学

Based on the service of stranded patients in D Hospital, this study aimed to explore the multiple needs of stranded patients and construct an intervention mode from the ecosystem perspective. Using the method of case study, taking the service of stranded patients in hospital D as an example, 49 case records and verbatim interviews with stakeholders were analyzed. The discharge and resettlement of stranded patients faces multiple obstacles from individuals, families, medical and social systems. This study constructed the social work intervention model from the ecosystem perspective: information collection and needs assessment, empowerment of individual system, reconstruction of family support system, coordination of medical system and linking social support system. The intervention process achieved efficient effects. Social work intervention of stranded patients should pay attention to patients’ psychosocial needs and improve awareness of system difficulties; mobilize the multi-system support network and deliver services in combination with case management method; conduct social advocacy for the breakthrough of law and policy.

Effect and mechanism of matrine on steatosis Chang Liver cells induced by oleic acid / 中国药房

OBJECTIVE To investigate the effects of matrine （MT） on steatosis Chang Liver cell model induced by oleic acid （OA） and its possible mechanism. METHODS Chang Liver cells were divided into blank group， model group and MT low-dose， medium-dose group and high-dose groups （0.1， 0.5， 1.0 mmol/L）. Except for blank group， the other groups were treated with 1.0 mmol/L OA for 24 h to establish steatosis model， and MT groups were given corresponding concentrations of drugs for 24 h. The activities of steatosis Chang Liver cells were observed； the morphologies of intracellular lipid droplets were observed and lipid content was also determined. The contents of liver function indexes [alanine transaminase （ALT）， aspartate transaminase （AST）， total bilirubin （TBIL）， alkaline phosphatase （ALP）]， as well as mRNA and protein expressions of farnesoid X receptor （FXR）， cytochrome P450 7A1 （CYP7A1） and fibroblast growth factor 19 （FGF19） were all detected. RESULTS OA and MT had no significant effect on the activity of Chang Liver cells. After OA treatment， orange lipid droplets formed in cytoplasm； compared with blank group， relative lipid content and the levels of liver function indexes were increased significantly， while the mRNA and protein expressions of FXR， CYP7A1 and FGF19 were down-regulated significantly （P＜0.05）. After treatment of low， medium and high concentrations of MT， above indexes were all reversed significantly （P＜0.05）. CONCLUSIONS MT could significantly improve the lipid content and liver function indexes of steatosis Chang Liver cells induced by OA though regulating FXR/CYP7A1/ FGF19 signaling pathway.

Research progress of improving subclinical atherosclerosis with exercise / 上海预防医学

Atherosclerosis is the main cause of cardiovascular diseases， while Carotid intima-media thickness is a biomarker of subclinical atherosclerosis. Numerous studies have confirmed that exercise can slow down or even reverse the formation and progression of carotid Intima-Media thickness. This paper provides a review of the effects of different exercise modalities， intensities， and populations on the vascular structure to provide a reference for the prevention of atherosclerosis with exercise.

Identification of risk genes in Chinese nonobstructive azoospermia patients based on whole-exome sequencing / 亚洲男科学杂志(英文版)

Nonobstructive azoospermia (NOA) is a severe condition in infertile men, and increasing numbers of causative genes have been identified during the last few decades. Although certain causative genes can explain the presence of NOA in some patients, a proportion of NOA patients remain to be addressed. This study aimed to investigate potential high-risk genes associated with spermatogenesis in idiopathic NOA patients by whole-exome sequencing. Whole-exome sequencing was performed in 46 male patients diagnosed with NOA. First, screening was performed for 119 genes known to be related to male infertility. Next, further screening was performed to determine potential high-risk causative genes for NOA by comparisons with 68 healthy male controls. Finally, risk genes with high/specific expression in the testes were selected and their expression fluctuations during spermatogenesis were graphed. The frequency of cystic fibrosis transmembrane conductance regulator (CFTR) gene pathogenic variant carriers was higher in the NOA patients compared with the healthy controls. Potential risk genes that may be causes of NOA were identified, including seven genes that were highly/specifically expressed in the testes. Four risk genes previously reported to be involved in spermatogenesis (MutS homolog 5 [MSH5], cilia- and flagella-associated protein 54 [CFAP54], MAP7 domain containing 3 [MAP7D3], and coiled-coil domain containing 33 [CCDC33]) and three novel risk genes (coiled-coil domain containing 168 [CCDC168], chromosome 16 open reading frame 96 [C16orf96], and serine protease 48 [PRSS48]) were identified to be highly or specifically expressed in the testes and significantly different in the 46 NOA patients compared with 68 healthy controls. This study on clinical NOA patients provides further evidence for the four previously reported risk genes. The present findings pave the way for further functional investigations and provide candidate risk genes for genetic diagnosis of NOA.

Effect of high-intensity interval training on executive function for healthy children and adolescents: a systematic review / 中国康复理论与实践

ObjectiveTo systematically review the effect of high-intensity interval training (HIIT) on executive function for healthy children and adolescents, and delineate the factors related to the intervention outcome. MethodsLiterature about the effect of HIIT on executive functions for healthy children and adolescent was retrieved from Web of Science, PubMed, Cochrane, Embase, Google Scholar, and CNKI, up to July 31st, 2023. The methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and relevant data were systematically reviewed. ResultsFifteen researches were included, from nine countries, comprising 13 randomized controlled trials with the scores of PEDro scale from five to eight, involving 17 021 participants aged six to 18 years. They were published mainly from 2016 to 2023. The primary factors related to the intervention outcome were the age of participants, HIIT intervention programs, and work-to-rest ratio. HIIT significantly improved working memory and inhibitory control in healthy children, while it was limited for adolescents. ConclusionHIIT can significantly improve inhibitory control and working memory in healthy children. Key factors related to the intervention outcomes include the age of participants and the specifics of the HIIT program, etc.

Current situation and policy suggestions of medical social work supervision in shanghai / 中华医院管理杂志

Objective:To investigate the current situation of medical social worker supervision in Shanghai, for reference to promote the high-quality development of medical social work.Methods:From June to July 2022, a questionnaire survey was conducted on the in-service medical social workers in all medical institutions with medical social work departments or posts in Shanghai. The questionnaire mainly included demographic information, current status of supervision implementation, and effectiveness of supervision. The data were analyzed descriptively with t test for comparison between groups and the Pearson test was for correlation analysis. Results:A total of 99 medical social workers were included in this study, 65 had received supervision, and medical institutions where 58 people located had established the supervision system. The average scores of actual and expected supervisory support received by medical social workers were 3.71 and 4.20 respectively, and the mean burnout level score was 32.91. The effect of establishing a supervision institutions on burnout was statistically significant ( P<0.05) and actual access to supervision support was negatively associated with burnout ( P<0.05). Conclusions:The overall situation of medical social work supervision in Shanghai was positive, but the demand for supervision was not fully satisfied; Supervision had a positive impact on reducing the burnout level. It is suggested that medical social work should further strengthen the cultivation of supervisory talents, promote the construction of supervisory systems, and improve the quality of supervision.

Research on the Ethical Dilemmas of Medical Social Workers Involved in the Service Emergency Stranded Patients / 中国医学伦理学

The retention of emergency patients is a common problem faced by hospitals worldwide. In addition to medical problems, social, family, economic and other problems will also cause patients to stay in the emergency department. It not only brings challenges to patients’ own disease treatment and hospital operation and management, but also brings ethical dilemmas. Taking the service cases of medical social workers who involved in stranded patients in Shanghai E Hospital as an example, this paper analyzed 20 service records and interviews with social workers receiving cases, and combed the ethical dilemmas faced by medical social workers in the process of involving in emergency stranded patients. It was found that medical social workers faced many ethical dilemmas in the process of involving in emergency stranded patients, such as interpersonal relations and relevant legal regulations, the right to life and health and the right to informed consent, the self-determination of case owners and the allocation of medical resources. In this regard, it is suggested to solve the problem of patient retention by advocating the improvement of relevant systems and policies, building cooperative teams to smooth referral channels, strengthening education, and promoting family shared decision-making.

Delicaflavone inhibits the invasion and migration of gefitinib-resistant lung cancer PC-9/GR cells by regulating epithelial-mesenchymal transition via PI3K/Akt/mTOR pathway / 中国临床药理学与治疗学

AIM: To study the effect and mechanism of Delicaflavone on migration and invasion of gefitinib-resistant lung cancer cell line PC-9/GR. METHODS: MTT assay was used to detect cell viability. Transwell and scratch assays were used to detect cell invasion and migration abilities. Western blotting was used to detect the expressions of MMP-9, MMP-2, E-cadherin, N-cadherin, Vimentin and PI3K/Akt/mTOR pathway-related proteins in PC-9/GR cells. RESULTS: Compared with control group, 20 mg/L Delicaflavone could significantly inhibit the viability of PC-9/GR cells for 24 h (P<0.05), while Delicaflavone below 10 mg/L had no significant effect on cell proliferation. The number of invasive cells and migrated cells were decreased significantly by Delicaflavone in a concentration-dependent way (P<0.05 and P<0.01). Delicaflavone could concentration-dependently reduce the expression of MMP-9, MMP-2, N-cadherin, vimentin (P<0.01), meanwhile up-regulate the expression of E-cadherin (P<0.01). In addition, Delicaflavone also decreased the expression of p-PI3K, p-Akt and p-mTOR in a concentration-dependent manner (P<0.01). CONCLUSION: Delicaflavone can inhibit the migration and invasion of PC-9/GR cells by regulating epithelial-mesenchymal transition via PI3K/Akt/mTOR pathway.

SUMO E3 ligase mediates androgen receptor transcription to promote tamoxifen resistance of breast cancer / 中国临床药理学与治疗学

AIM: To investigate the mechanism of the involvement of SUMO-ylated Androgen receptor (AR) in tamoxifen resistance and the role of SUMO inhibitor ginkgolic acid in resistance. METHODS: Real-Time PCR was used to detect AR mRNA levels in parental cells MCF-7W and drug-resistant cells MCF-7R, AR protein levels and SUMO levels in MCF-7W and MCF-7R cells was performed by western blot, and CB/IP was applied to detect AR interacts with SUMOE3 ligase PIAS1 and HSP27 in MCF-7R cell chromatin, the transcriptional activity of SUMO AR was also evaluated by the fluorescent reporter gene experiment, the CCK-8 method and the trypan blue exclusion method were used to detect cell viability and cell viability respectively. RESULTS: The mRNA and protein expression levels of AR in MCF-7R cells were significantly higher than those in MCF-7W cells (P<0.05), and there was highly SUMOylated AR in MCF-7R cells. Further research found that there had an obvious interaction between AR and SUMO E3 ligase PIAS1 and HSP27, that was, the SUMOylated AR was modified by E3 ligase. Moreover, androgen R1881 could enhance the transcriptional activity of the SUMOylated AR in a concentration-dependent manner. Compared with ginkgo acid alone, 10 μmol/L of ginkgolic acid combined with 10 μmol/L of enzalutamide treated MCF-7R cells for 3 days, the cell number was significantly reduced, and the number of cell death increased significantly (P<0.05). CONCLUSION: The resistance mechanism of tamoxifen may be due to the enhanced AR transcription and activity increased by the hyperactive SUMOylated AR, SUMO inhibitor ginkgolic acid combined with AR antagonist enzalutamide can be a new strategy for the treatment of tamoxifen resistance.

Construction of mammary gland cell-specific SENP7 knockout mice by Cre-loxP system / 中国临床药理学与治疗学

AIM: To construct and identify the mammary gland cell-specific conditional knockout of SENP7 by the Cre-loxP system. METHODS: The homozygous SENP7

Application of natural deep eutectic solvents in pharmaceutics / 药学学报

Natural deep eutectic solvent (NDES) is a kind of deep eutectic solvents (DESs) which is composed of natural substances with good biocompatibility. Those substances can function as hydrogen bond donor and acceptor, such as choline, amino acids, sugars, etc. NDES have been widely used in many fields due to their advantages of low cost, easy preparation and environmental friendliness. It is especially suitable for the pharmaceutical industry because of its good biocompatibility and safety for use. In this paper, we firstly review the molecular simulation methods for current design of DESs from the formation principle. And then, the materials and preparation of NDES are reviewed and the physicochemical properties are further described. Finally, we review the current application of NDES in pharmaceutics including increasing drug solubility, promoting drug permeability and enhancing oral drug absorption, and meanwhile their future applications in pharmaceutics were also prospected.

Research progress in polymeric microspheres in oral drug delivery system / 国际生物医学工程杂志

As a drug carrier, polymer microspheres have been widely used in oral drug delivery systems, which can achieve the purposes of protecting drug stability, slowing drug release, enhancing immunity, and improving drug absorption. The polymer materials used in the preparation of microspheres can be derived from natural substances, such as cellulose, polysaccharides, and proteins. These materials can also be derived from synthetic polymer substances, such as polycaprolactone and polylactic acid. In this paper, the role of microspheres in oral drug delivery and the types of oral microspheres were reviewed to provide references for in-depth research and development of oral microspheres.

An exploratory study of quantitative analysis of gait characteristics in patients with early Parkinson′s disease / 中华神经科杂志

Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.

Molecular Mechanism of Ligustri Lucidi Fructus-Astragali Radix for Anti-cancer Based on Network Pharmacology / 中国实验方剂学杂志

Objective: To screen out active ingredients, and predict the anti-cancer targets of Ligustri Lucidi Fructus-Astragali Radix based on the "herbs-active ingredient-action targets" network. Method: The traditional Chinese medicine (TCM) system pharmacology platform (TCMSP) was employed to screen out the active ingredients and putative targets of anti-cancer of glossy privet fruit and astragalus. DisGeNET database and Online Mendelian Inheritance in Man (OMIM database) were employed to predict the targets for treating cancer, and then "herbs-active ingredients-key targets" network was constructed by using Cytoscape software. The omicshare platform was employed to match the putative targets of ingredients and the targets for treating cancer. Finally, the protein interaction network of key targets was constructed by using String database, and the analysis of biological functions and pathways of them was carried out by using DAVID database. Result: Totally 33 drug active ingredients were screened out, involving a total of 203 targets, and 14 of them were related to cancer. These 14 key targets played an therapeutic role in treating cancer by regulating target proteins, such as ERBB2, AR, SRC, EGFR, ESR1, as well as proteoglycans in cancer, cancer pathways, microRNAs in cancer and other pathways. Conclusion: The therapeutic mechanism of Ligustri Lucidi Fructus-Astragali Radix reflects the multi-component, multi-target, and multi-pathway characteristics of TCMs, providing the scientific basis for further study and the material basis of Ligustri Lucidi Fructus-Astragali Radix against cancer.

The miss rate analysis of anti-HLA antibodies detection for kidney transplantation preoperative recipients with sensitization history based on luminex xMAP / 中华器官移植杂志

Objective To interrogate the detection of anti-HLA antibodies using two methods of Luminex xMAP,and to compare their detection capacity and to analyze their misdetection rate for initial screening,providing more accurate results in clinical practice.Methods 214 serum samples from recipients with a history of sensitization before renal transplantation were collected and detected by LM (LABScreen Mixed) and LSA (LABScreen Single Antigen) respectively on the Luminex xMAP platform.Results For the LM detection,the positive rates of anti-HLA class Ⅰ and Ⅱ were 50.9％ and 23.4％ respectively,which were lower than those used by the LSA detection (58.9％ and 46.7％ respectively).The difference had statistical significance (P ＜ 0.05).The sensitivity,specificity,miss rate and mistake rate of anti-HLA class Ⅰ and Ⅱ[detection were 80.2％,90.9％,19.8％,9.1％ and 49.0％,99.1％,51.0％,0.9％ respectively.The missed detection gene with the highest rate was Cw * 17:01,B * 15:12,B * 45:01 for anti-HLA class Ⅰ and DPA1 * 01:03,DPB1 * 06:01,DPA1 * 01:03,DPB1 * 01:01 for anti-HLA class Ⅱ.The highest MFI value was 10603 and 3659.For the recipients with only blood transfusion history or pregnancy history,LM and LSA detection showed no statistically significant difference when detecting anti-HLA class Ⅰ antibodies,but had statistically significant difference when testing anti-HLA class Ⅱ antibodies.For the patients with history of both blood transfusion and pregnancy history,LM and LSA showed no significant difference in the detection of anti-HLA class Ⅰ antibodies and anti-HLA class Ⅱ antibodies.The miss rate of anti-HLA class Ⅰ antibody detection was lower than that of anti-HLA class Ⅱ antibody detection.Conclusion LSA detection has the higher sensivity and lower miss rate than LM detection.In the light of the disadvantage of LM detection as diagnostic preliminary screening,it is suggested that LSA detection should be used directly for the recipients with a history of sensitization.By this process optimization,it is more likely to cause missent inspection and the occurrence of rejection,as well as a poor long-term survival rate.

Clinical observation of hepatitis B virus carriers after renal transplantation / 器官移植

Objective To observe the changes of liver and kidney function in hepatitis B virus(HBV)carriers after renal transplantation. Methods A total of 116 patients with HBV infection undergoing renal transplantation and 348 counterparts without HBV infection were recruited in this clinical trial. The liver function parameters including alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels and renal function parameter including serum creatinine(Scr)level were measured before and at 1, 3, 6, 12, 18, 24, 36 and 60 months after renal transplantation. Preoperative and postoperative changes of liver and kidney function were statistical y compared between the hepatitis B surface antigen(HBsAg)(+)and HBsAg(–)groups. According to the results of preoperative HBV serology, preoperative quantitative detection of HBV DNA and preoperative liver function test, 116 HBsAg(+)patients undergoing renal transplantation were divided into(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, HBV DNA(+)and HBV DNA(–)groups, and normal and abnormal liver function groups.Preoperativeandpostoperativechangesofliverandkidneyfunctionwerestatisticalycomparedbetweendifferentsubgroups. Results(1)Preoperative ALT and AST levels in HBsAg(+)patients were significantly higher compared with those in their HBsAg(–)counterparts. In 36 months after renal transplantation, liver function parameters significantly differed between two groups(al P<0.05), whereas no statistical significance was noted at postoperative 60 months(al P>0.05). Before and in 60 months after renal transplantation, no statistical significance was observed in the Scr levels between the HBsAg(+)and HBsAg(–)groups(all P>0.05).(2)Before and in 60 months after renal transplantation, no statistical significance was observed in the liver and kidney function parameters between the(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, and HBV DNA(+)and HBV DNA(–)groups(all P>0.05).(3)The ALT levels before and at 1, 3, 6 and 12 months after renal transplantation significantly differed between the normal and abnormal liver function groups(al P<0.05), whereas no statistical significance was observed at other time points(all P>0.05). The AST levels before and at 1 month after renal transplantation significantly differed between two groups(both P<0.05), whereas did not significantly differ at alternative postoperative time points(all P>0.05). No statisticalsignificancewasobservedinthekidneyfunctionparametersbeforeandat60monthsfolowingrenaltransplantation between two groups(al P>0.05). Conclusions HBV infection cannot exert significant effect upon kidney function within 5 years after renal transplantation, whereas it can affect short-term postoperative liver function.

Effect of Compound Zhajin Granule on Toll-like Receptor 4 Signaling Pathway in Nonalcoholic Steatohepatitis Mice / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Compound Zhajin Granule (CZG) on Toll-like re-ceptor 4 (TLR4) signaling pathway in high-fructose corn syrup induced NASH mice.</p><p><b>METHODS</b>Thirty 6-week-old male C3H mice were divided into the high fat and high fructose (HFHFr) group (n = 20) and the control group (n = 10) according to body weight. Mice in the HFHFr group ate high fat diet and drank 20% fructose water, while those in the control group ate common diet and drank common water. After 8 weeks mice in the HFHFr group were divided into two group according to body weight, the HFHFr group and the CZG group, 10 in each group. Mice in the CZG group were fed with high fat forage and 20% fructose water, and administered with 50 mL/kg 12. 8% CZG (prepared by hawthorn, Radix Curcumae, Alisma Orientale, Fritillaria Thunbergii, Silybum Marianum, peach seed in the ratio of 3:1.5:1.5:2:1.5:2:1) by gastrogavage. Mice in the HFHFr group were fed in the same way and daily administered with equal volume of distilled water by gastrogavage. Sixteen weeks later all mice were sacrificed. Body weight, liver wet weight, liver function, and lipid metabolism were detected. Pathological changes of liver tissues were assessed by HE staining, oil red O staining, and Masson staining. Expressions of TLR4, myeloid differentiation factor 88 (MyD88), tumor necrosis factor-alpha (TNF-α) were detected using immunohistochemical staining and real-time fluorescent quantitative PCR.</p><p><b>RESULTS</b>Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST) were obviously lower in the CZG group than in the HFHFr group (P < 0.05); oil red O stained area and density were decreased more in the CZG group than in the control group. HE staining showed ballooning inflammation was reduced more in the CZG group than in the HFHFr group. Masson staining was negative. Positive rates of TLR4 and MyD88 and mRNA expressions were significantly lower in the CZG group than in the HFHFr group (all P < 0.05).</p><p><b>CONCLUSION</b>CZG could significantly inhibit TLR4 signaling pathway of liver in NASH mice.</p>

Clinical experience on postoperative balance of hemostasis and antithrombus for patients with hemophilic arthritis after arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical significance of postoperative personalized antithrombotic therapy for patients with hemophilic arthritis (HA) patients after arthroplasty.</p><p><b>METHODS</b>From September 2005 to October 2013, 11 cases of arthroplasty for hemophilic arthritis in hip and knee total operation 14 times,including 1 case of double knees (calculated as one operation), operation in left knees 6 times, operation in right knees 5 times, 2 in hip. All the patients were male and the age ranged from 23 to 57 years old,with an average of (36.1 ± 11.0) years old; the average weight was (64.1 ± 8.9) kg. All the patients were preoperatively diagnosed and classified as hemophilic arthritis with the radiological images and laboratory tests. According to the function of joints, the risk of postoperative venous thromboembolism (VTE), and dynamic observation of Factor VIII:C (FVIII:C) activity, patients were treated with personalized antithrombus by adjusting the dosage of recombinant human coagulation factor VIII (Kogenate FS). All the patients were orderly divided into postoperatively distal joints moving group and none-moving group to observe the coagulation function.</p><p><b>RESULTS</b>The enrolled patients had no postoperative complication of VTE and pulmonary embolism (PE). The APTT and D-2 were different between two groups in the postoperative early stage. Length of hospital day was shorter in the moving group than none-moving group.</p><p><b>CONCLUSION</b>Because of the self-coagulation disorder, patients with HA tended to bleed. However it doesn't mean that there is no risk of postoperative thrombosis. Therefore,it's important to determine how to control the balance between postoperative antithrombus, hemostasis,and coagulation factor replacement therapy after arthroplasty for HA. Postoperative moving has proved helpful for HA, especially in reducing the risk of hemostasis and shortening the time in hospital.</p>

SenseWear Pro Armband：a monitoring device of physical activity energy consumption / 中国组织工程研究

BACKGROUND:SenseWear Pro Armband (SWA) is a monitoring device of physical activity energy consumption which consists of many kinds of motion sensors, and it has been widely used in the study of physical activity energy consumption in recent years. OBJECTIVE:To summarize the SWA accuracy, software version, time of wear as wel as its application in different populations and at different physical activity levels, for the purpose of providing some practical reference in the future usage of SWA. METHODS:A computer-based search of CNKI (ful-text database), PubMed and Web of Science databases was done for relevant articles published before January 2015 using the keywords of “physical activity, sensewear pro armband, energy expenditure, review” in Chinese and English, respectively. Articles published in core journals or SCI database were preferred. RESULTS AND CONCLUSION:Double labeled water method and indirect measurement method serve as standard criteria, and the relevant study shows that SWA has higher accuracy and can effectively evaluate the daily physical activity energy consumption. But under the special circumstances, there are some differences, such as different people and different exercise intensities. Meanwhile, to determine the appropriate wearing time and software version for data statistics are also one of the factors influencing the accuracy of the final result. SWA can accurately predict physical activity energy consumption, but for different populations and exercise intensities, it is necessary to improve the further calculation formula of SWA.

Clinicopathologic features and differential diagnosis of multilocular cystic renal cell carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and the diagnosis of multilocular cystic renal cell carcinoma (MCRCC).</p><p><b>METHODS</b>The clinicopathological data of 19 MCRCC cases were collected and immunohistochemical staining assays were carried out. Forty-six cases of other cystic kidney lesions within the same period were collected as controls, including extensively cystic clear cell RCC (12 cases), clear cell tubulopapillary renal cell carcinoma (6 cases), tubulocystic carcinoma (2 cases), simple cortical cysts (22 cases), multilocular cystic nephroma (1 cases) and multicystic kidney (3 cases).</p><p><b>RESULTS</b>The patients included 14 males and 5 females. The ages ranged from 31 to 66 years (median age = 50 years). Most of the MCRCC cases were detected incidentally in physical examination, occasionally accompanied with hematuria, back pain or other symptoms. The follow-up period of 17 patients ranged from 6 to 170 months. All patients were alive without evidence of tumor recurrence or metastasis. Pathological findings showed that macroscopically, tumor size ranges from 1.5 to 7.0 cm in the maximum diameter, generally a entirely of various sized. The cysts contain serous, hemorrhagic or turbid fluid. Solid areas or substantially discernible mural nodules were absent; histologicallly, single layer of cuboidal and flattened epithelial tumor cells were lined in the cysts, described as clear cytoplasm, small nuclear, no nucleoli and low Fuhrman nuclear grade (I or II). Multilayer tumor cells could be observed in a few cysts, with granular cytoplasm and small intracystic papillae formed. The clear tumor cell clusters, similar as cystic lined tumor cells, were seen within pathological fibrous in almost all cases, and significant myofibroblastic proliferation was found in 14 cases. Immunohistochemically, the cysts lined epithelial cells and the clear tumor cell clusters were positive for epithelium markers, including CKpan(19/19), EMA(16/19) and CK7 (15/19); higher percentage of CAIX (17/19) and PAX8(15/19) than control groups, but lower percentage of CD10 (7/19), RCC (6/19) and AMACR(2/19); and all were negative for 34βE12, CD117 and CD68.</p><p><b>CONCLUSIONS</b>Multilocular cysts, clear cells clusters of low Fuhrman grade within fibrous septa and capillary vessel proliferation under epithelium are important features of MCRCC. The united using of CAIX, CK7, CD10 and RCC is helpful for differentiating variable cystic renal tumor. MCRCC usually has an excellent prognosis, nephron sparing surgery is first recommended as a therapeutic strategy.</p>