Aim To study the role of the total flavonoids from arachniodes exilis(TFAE) in osteogenic differentiation of human umbilical cord mesenchymal stem cells(hUCMSCs).Methods hUCMSCs were isolated and cultured by tissue explants adherent method, hUCMSCs at passage 3 were used to do the experiment, hUCMSCs were treated by different concentrations of TFAE, and cellular viability was measured by CCK 8 assay;alkaline phosphatase(ALP) activity was tested by AMP method;calcium nodule formation was detected by alizarin red staining;expression level of osteogenesis-related gene type I collagen enzyme a1(collagen type Ia1, Col1a1), osteopontin(OPN), Runx2, Osterix(Osx) mRNA was measured by RT-PCR;expression level of Col1a1,OPN protein was measured by Western blot.Results Certain concentration of TFAE(1 mg·L-1, 5 mg·L-1) promoted cellular proliferation, calcium nodules were more, ALP activity was enhanced;expression level of osteogenesis-related gene Col1a1, OPN, Runx2, OsxmRNA and Col1a1, OPN protein was up-regulated.Conculsion A certain concentration of TFAE promotes proliferation and osteogenic differentiation of hUCMSCs.

Objective To investigate the values of clinical examinations and ultrasonography in diagnosing acetabular labrum injury . Methods Fifty-three hip dysfunction patients consisting 60 hips were enrolled in this research ,include 46 unilateral hips and 7 bilateral hips . Patients underwent physical examinations such as impingement test ,FABER test and resisted straight leg raise test ,then they underwent ultrasound examitation to observe the morphology ,boundry and internal echo of the labrum . The types of tears were classified into radial flaps( Ⅰ type) ,radial fibrillated( Ⅱ type) ,longitudinal peripheral( Ⅲ type) and unstable ( Ⅳ type) by Lage Classification system .The purpose of this study was to evaluate the application values of the sonographic findings and clinical examinations according to arthroscopic or intraoperative findings as gold standard in diagnosis of labral tears of the hip ,as well as evaluate the accuracy in diagnosis the type of tears . Results ① The sensitivity ,accuracy and positive predictive value for the diagnosis of acetabular labrum tears by sonography were 81 .1% ( 47/58) ,78 .3% ( 47/60) and 95 .9%( 47/49 ) . And the sensitivity , specific , positive predictive value and negative predictive value for the diagnosis of anterosuperior labrum tears by sonography were 95 .9% ( 47/49) ,81 .8% ( 9/11) ,95 .9% ( 47/49) ,81 .8% (9/11) ;the accuracy of sonographic in diagnosis the types of tears was 92 .3% ( Ⅰ type) ,90 .9%( Ⅱ type) ,80 .0% ( Ⅲ type) and 86 .7% ( Ⅳ type) respectively ; ② The accuracy of clinical examinations in diagnosing acetabular labrum tears were 89 .5% ( impingment test) ,60 .0% ( FABER test) and 75% ( resisted straight leg raise test) ;sonographic has a higher veracity in diagonoses of anterosuperior labrum tears than any clinical examinations . Conclusions Sonographic can efficiently diagonose anterosuperior labrum tears , and would be highly used in classified the types of labrum tears .

Aim To study the effect of silymarin on proliferation and apoptosis of human osteosarcoma saos-2 cells and to explore its possible mechanisms .Meth-ods Control group and different concentration groups of silymarin were set , and Saos-2 cells were treated with silymarin .Celluar morphologic changes were ob-served by inverted phase contrast microscope .Prolifer-ation of cells was tested CCK-8 assay .Apoptosis rate of cells was analyzed by flow cytometry . ERK1/2、p-ERK1/2 and cleaved caspase-3 protein expression were measured by Western blot .Results Silymarin inhibi-ted the proliferation of Saos-2 cells in a time-dependent and concentration-dependent manner . Silymarin in-duced the apoptosis of Saos-2 cells in a concentration-dependent manner . Silymarin decreased p-ERK1/2 protein expression and increased cleaved caspase-3 protein expression in a concentration-dependent man-ner, while ERK1/2 protein expression had no obvious change.Conculsions Silymarin can inhibit the prolif-eration of human osteosarcoma saos-2 cells and induce apoptosis of them , and the mechanism may be related to inhibition of ERK signaling pathway and upregulated caspase-3 protein expression .

Objective To evaluate the left ventricular flow field characteristics in patients with obstructive and non-obstructive hypertrophic cardiomyopathy (HCM) using vector flow mapping (VFM),then assess the left ventricular hemodynamics.Methods 40 patients with HCM were randomly selected as case group,among which 20 patients with left ventricular outflow tract(LVOT) obstruction (group Ⅰ) and 20 patients without LVOT obstruction(group Ⅱ),40 healthy adult volunteers served as control group.The conventional parameters:left ventricular ejection fraction(LVEF),interventricular septal thickness and radial and pressure gradient of left ventricular outflow tract and VFM parameters:left ventricular peak systolic velocity (Vs),systolic flow (Fs),total negative systolic flow (SQ-) and vortex parameters were measured and compared.The correlation between LVOT pressure gradient and VFM parameters were assessed.Results There was no significant difference of LVEF in three groups.Compared with control group,interventricular septal thickness in group Ⅰ and group Ⅱ was much higher(P ＜0.05).Radius in group Ⅰ was much lower than that of group Ⅱ and pressure gradient of LVOT in group Ⅰ was significantly higher compared with group Ⅱ (P ＜0.05).Comparison of VFM parameters:①Compared with control group,SQ-of basal segments in case groups were lower (P ＜0.05),while SQ-of mid and apical segments were higher(P ＜ 0.05),Vs and Fs of all segments increased (P ＜0.05),and number of vortex,vortex diameter and vorticity of obstruction and non-obstruction groups were higher(P ＜0.05).②Compared with group Ⅱ,SQ-of basal segments decreased and SQ-of mid and apical segments increased in group Ⅰ,Vs and Fs of all segments were higher.The number of vortex,vortex diameter were higher in group Ⅰ (P ＜ 0.05).③ Correlation analysis:Fs in apex,the number of vortex relatively correlated with press gradient of LVOT(r =0.60,0.65,respectively).Conclusions VFM can effectively evaluate the flow field characteristics of left ventricle in patients with obstructive and non-obstructive HCM,and Fs in apex,number of vortex were correlated with the degree of obstruction,then further assess the left ventricular hemodynamics quantitively.

The Rh blood grouping system is a critical standardized test in transfusion medicine,espe-cially for the cases related to haemolytic transfusion reactions and neonatal haemolytic disease caused by clinical RhD blood group incompatibility.In the present case report,we presented two cases with the un-common RHD gene variation RHD*DEL37.The blood samples of the two subjects were mistakenly iden-tified as RhD-negative through conventional serological testing.Firstly,both blood samples were tested negative for the RhD antigen using traditional tube test and gel microcolumn methods.The phenotyping of RhCE were identified as ccEe and ccee for each sample,respectively.Secondly,genetic analysis was performed using polymerase chain reaction-sequence specific prime(PCR-SSP)which revealed that nei-ther sample belonging to the several common RHD gene variants which was found in Asia.Moreover,they turned out to be positive for the RHD haplotype,which indicated that exons 1-10 on one of the RHD al-leles were entirely absent.In addition,a T＞C mutation was observed at bases 1154-31 in intron 8 of the other allele,which was located at the intron 8 breakpoint.This result was obtained after further Sanger sequencing of exons 1-10 of the RHD gene.The mutant allele was designated as RHD*DEL37 by the International Society of Blood Transfusion(ISBT)and was identified as D-elute(Del)by phenotype ana-lysis.Both samples were genotyped as RHD*DEL37 and showed positive results.In summary,the true genotype of the two blood samples,of which the screening results only using serological testing method was negative,were RHD*DEL37/RHD-(RHD*01N.01).Notably,this kind of genotype was reported for the first time in Chinese population.Moreover,the two individuals did not have ties of consanguinity,indicating that some of the Chinese individuals could be carriers of the genetic mutation.Therefore,it might be necessary to further confirm the frequency of this mutation in the Chinese population and the possibility of homozygosity for this mutation.This report identifies infrequent RHD gene mutation samples by coupling molecular biology and serological methods to prevent misclassification of blood groups.Com-bining serological and molecular biology test results to determine blood group is critical in protecting pa-tients during clinical transfusion procedures.

Objective:To analyze the influencing factors of community hospice care service needs of the elderly based on structural equation model.Methods:A multi-stage sampling method was used to survey 564 elderly people from 40 community health service centers in four districts of Chaoyang District in Beijing from September to November 2020 with a self-designed questionnaire. The survey content included three dimensions: tendency characteristics (population characteristics, health beliefs), enabling resources and demand factors. The chi-square test and rank sum test were used to analyze the influencing factors of the community hospice care needs of the elderly. At the same time, based on Anderson theory, structural equation model was used to analyze the action path and effect size of the influencing factors.Results:Registered residence, occupation, understanding of community elderly care services, recognition of community medical convenience, recognition of community health services in reducing family burden, recognition of community health services in improving their own health, understanding of community hospice care services, mean monthly income of their families, degree of income satisfaction, self-paid medical expenses of the previous year, living status, acceptance of community medical expenses, satisfaction with the number of community medical staff, self-assessment of health status, whether the elderly was ill in the last two weeks and the number of chronic diseases and etc affected the needs of the elderly for community hospice care services (all P<0.05). In the three dimensions of Anderson model, enabling resources had a direct effect, and could also be affected by demand factors indirectly, the total effect value was 0.404; demand factors had direct impact, and the effect value was 0.193; propensity characteristics exerted impact indirectly through enabling resources and demand factors, and the total effect value was 0.176. Among them, the acceptance of community health service fees in the enabling resource dimension has the greatest impact (FL=0.535), the number of chronic disease in the demand factor dimension had the greatest impact (FL=1.018), and the recognition of community health service in reducing family burden in the propensity characteristic dimension had the greatest impact (FL=0.612) (all P<0.05). Conclusions:There are various factors and action paths that affect the needs of community hospice care services for the elderly. Among them, the acceptance of community health service fees, the number of chronic disease, and the recognition of community health service in reducing family burden have a greater impact.

Objective To evaluate the application of high-throughput shell vial assay in a clinical laboratory for detection of respiratory viruses from patients with ILI in Guangzhou between January and June, 2009. Methods Six hundred and fifty-two pharyngeal swab specimens were taken from ILI patents. Centrifugation-enhanced shell vials including 4 cell lines (MDCK, Hep-2, LLC-MK2 and MRC-5) were used for culture of respiratory viruses for 2-3 days. The cultures were identified by observation of cytopathic effect (CPE) , hemmaglution or hemmadsorption test as well as immunofluorescence staining. Results A total of 161 swab samples (24.69% ,161/652) were shown to have any one of the 5 common respiratory viruses including influenza A viruses ( 38. 51% , 62/161 ), influenza B virus ( 54. 65% , 88/161 ), parainfluenza viruses (4. 96% , 8/161 ) , adenovirus ( 1. 24% , 2/161 ), and respiratory syncytial virus (0. 62% ,1/161). The turnaround time was 2d for influenza viruses, 3d for adenovirus and parainfluenza viruses respectively. Conclusions (1) The shell vial method was effective, rapid and high throughout for the detection of respiratory viruses in clinical laboratories.(2)Influenza viruses were dominant in the swab samples from patients with ILI in Guangzhou between January and June with the highest appearance in the summer influenza B vires was the most common pathogen in patients with ILI in this study.

Objective: The current study aimed to determine the prevalence of high blood pressure (HBP) among children and adolescents aged 7-17 years in Suzhou by using different references, and to provide a reference for the application of standard of blood pressure among children. Methods: Data of 6 972 children and adolescents aged 7 to 17 years were collected by stratified cluster random sampling method to determine the prevalence of HBP based on 2017 AAP Guidelines for Childhood Hygertension(America 2017), National Blood Pressure Reference for Chinese Han Children based on Chinese National Survey on Students’ Constitution and Health in 2010 (Ma 2017), blood pressure guidelines based on their investigation in mainland children and adolescents (Mi 2017) and blood pressure guidelines based on data from the China Health and Nutrition Survey during the year of 1999-2009 (CHNS 2013). Results: Referred to Ma 2017 reference, the prevalence of HBP was highest with 12.7%, followed by America 2017 with 16.3%, Mi 2017 with 17.4%, and CHNS2013 with 25.5%. In boys, HBP prevalence based on America 2017 was close to that using Mi 2017 among children younger than 13 years old, and was close to that using Ma 2017 among those≥14 years old. In girls, HBP prevalence based on America 2017 was close to that using Mi 2017 among those≤12 years old, and was close to that using Ma 2017 among those ≥13 years old. Compared with America 2017 reference, kappa value based on Mi 2017 was better than Ma 2017 in boys(0.81, 0.77), opposite result was found in girls(0.86, 0.85). Kappa value were the lowest based on CHNS 2013. Conclusion The prevalence of HBP among children in Suzhou achieve a high level. Ma 2017, Mi 2017, and CHNS2013 references show different advantages among various gender and age groups.

Objective: To investigate the prevalence of depression and anxiety symptoms among middle school students in Taizhou, Zhejiang Province, and its associations with their educational burden, so as to provide a theoretical reference for making more targeted psychological interventional measures. Methods: A cross sectional study was conducted by multi stage cluster sampling from September to November 2022 from 30 schools in five districts and counties of Taizhou, with a final sample of 8 128 junior and senior high school students completing the online surveys on the Questionnaire Star platform. The Educational Stress Scale for Adolescents (ESSA) was used to measure academic stress; the Child Depression Inventory (CDI) and the Generalized Anxiety Disorder Scale (GAD-7) were used to screen students depression and anxiety, respectively. The relationships between educational burden and depression and anxiety symptoms were analyzed by Logistic regression models. Results: The prevalence of depression and anxiety were 19.3% and 11.1%, respectively. The average score of middle school students study pressure was (52.8±11.5). The number of extracurricular classes was <1, the time length of extracurricular courses was <1 hour per day, and students averagely spend 3.6 hours per day on homework assigned by school teachers. Nearly 30.0% students had ≤0.5 of discretionary time school days and 28.5% students had ≤2 on weekends. About 30.8% students though they do worse in their academic performance. According to the results of binary Logistic regression analysis, after controlling the demographic variables, the score in Study Pressure Scale, the number of extracurricular classes, the volume of homework and the time length of extracurricular courses were positively associated with depression and anxiety ( OR =1.09, 1.07, 1.08, 1.05, 1.04, 1.08, 1.08, 1.08, 1.06, 1.09, 1.07, 1.47, 1.34, 2.84 ; 1.08, 1.06, 1.08, 1.04, 1.03, 1.05, 1.05, 1.05, 1.05, 1.07, 1.06, 1.48, 1.23, 1.75, P <0.05). Students with overage grades had a higher risk of depression symptoms ( OR=1.34, P <0.05). Conclusions Academic burden has negative effects on depression and anxiety of students in Taizhou. It is advisable to alleviate academic stress, so as to improve the mental health of students.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of different molecular subtypes of breast cancer . Methods Sixty-two cases breast cancer patients with 62 breast lesions confirmed as breast cancer by postoperative pathology were selected . Referencing of St . Gallen standard and according to immunohistochemical markers of estrogen receptor ( ER) ,progesterone receptor(PR)andhumanepidermalgrowthfactorreceptor2(Her-2)expression,allthecasesweredivided into Luminal epithelium A or B ( Luminal A/B) subtype( 26 patients ) ,Her-2 over-expression subtype( 16 patients) and triple negative ( TN ) subtype ( 20 patients ) . CEUS and routine ultrasonography were performed for all patients before surgery ,and the contrast enhancement patterns and perfusion parameters were recorded . Whether there was a difference between the contrast enhancement patterns and perfusion parameters in different subtypes of breast cancer was analyzed . Results ① The contrast enhancement pattern showed more radioactive gathering( 76 .9% , P ＜0 .05) ,lower perfusion(69 .2% , P ＜ 0 .05) ,and lower maximum intensity ( IMAX) in the Luminal epithelium subtype than those in the Her-2 over-expression subtype and the TN subtype(all P ＜0 .05) ;② The contrast enhancement pattern showed more cardiac enhancing (93 .8% , P ＜0 .05) ,perfusion defect(75 .0% , P ＜0 .05) ,and shorter peak time (TTP) in Her-2 over-expression subtype than those in the Luminal epithelium subtype and the TN subtype(all P ＜0 .05) ;③The pattern of the TN subtype contrast enhancement showed more clear boundary( 80 .0% ,P＜0 .05) ,comparing to the other two types ,the perfusion parameters was no significant different( P ＞0 .05). Conclusions Different molecular subtypes of breast cancer have different contrast enhancement patterns and perfusion parameters ,CEUS can provide valuable imaging information for the diagnosis of breast cancer molecular typing before surgery .