BACKGROUND: 6-minute walking test (6MWT) is a submaximal test, characterizing by easily processing and low cost, thus it is widely used in the clinic. However, how to change walking distance into maximal motor capacity needs to be further studied.OBJECTIVE: To study the correlation of 6-minute walking distance (D), work (W), peak oxygen uptake (VO_2 peak) and maximal oxygen uptake (VO_2 max) detected by Bruce.DESIGN, TIME AND SETTING: This study was performed at tshe Department of Rehabilitation Medicine, Zhongda Hospital affiliated to Southeast University from March to May 2009.PARTICIPANTS: A total of 25 healthy volunteers were enrolled, including 14 males and 11 females, with a mean age of (22.0±2.3) years.METHODS: All 25 subjects were tested with cardiopulmonary exercise testing (CPET) according to Bruce, VO_2 max and anaerobic threshold (AT) was detected respectively, then 6MWT" was adopted to detect 6-minute walking distance (D), work (W) and maximal oxygen uptake (VO_2 max) of subjects. Data of pulmonary gas exchange in breathing was detected by wireless remote sensor K4b~2 to obtain VO_2 max and VO_2 peak.MAIN OUTCOME MEASURES: ① Regularity of cardiac rate, oxygen uptake and respiratory frequency varied with time passing; ② Walking distance, work, oxygen uptake, cardiac rate and respiratory frequency were compared before and after testing; ③ Maximal oxygen uptake and anaerobic threshold with CPET were compared to peal oxygen uptake with 6MWT; ④ Correlation of distance, work between maximal oxygen uptake and peal oxygen uptake.RESULTS: There was no significant difference between AT from CPET and VO2 peak from 6MWT (P > 0.05). 6-minute walking distance was not correlated with either VO_2 peak or VO_2 max. However, 6-minute walking work was linearly correlated with both VO2 peak (r=0.779 7, P < 0.001) and VO_2 max (r=0.894 1, P < 0.001).CONCLUSION: 6-minute walking test is an exercise test at level of anaerobic threshold. 6-minute walking work can reflect both submaximal exercise capacity and maximal exercise capacity.

Objective:To study the difference of the development between mandibular condylar cartilage and femoral head cartilage in vitro.Methods:Mandibular condyles and femoral heads were sampled from 1 2 neonatal mice and cultured in vitro.The samples before culture and after 6-week culture were examined by gross observation,HE staining,Alizarin Red staining and PCNA immunohistochem-istry respectively.Results:After in vitro culture,abnormal changes were observed in condyle cartilage,but the surface area of condyle cartilage was not changed(P >0.05).HE staining showed partial cartilage layer structure disappearance and the Alizarin Red staining confirmed calcification in the cartilage matrix.However,calcification was not found in femoral head cartilage,and the surface area of femoral head cartilage increased(P <0.05).HE staining showed the hypertrophied layer was thicker after culture than before and the Alizarin Red staining showed there was no calcification in the femoral cartilage matrix.The immunohistochemistry displayed PCNA posi-tive expression in both cartilage after culture.Conclusion:In vitro,the mandibular condylar cartilage matrix can be spontaneously cal-cificated.

Purpose To study the clinicopathological features of lymphangiomyomatosis (LAM) of pelvis lymph node.Methods A patient with endometrial endometrioid adenocarcinoma and LAM was analyzed including clinical data and pathological features.HE and immunohistoehemistry of EnVision stainings were used,and the literatures were reviewed.Results Well-moderately differentiated endometrioid adenocarcinoma could be observed in the endometrium.Proloferation of LAM cells were seen in the capsule and medulla of the pelvic lymph node.The LAM cell was spindle,epitheliod and polygonal cells with oxyphilic or clear cytoplasm which arranged surrounding lacunes.The LAM cells showed no atypia and mitosis could not seen.The tumor cells showed diffusely positive for SMA,Caldesmon,desmin,vimentin,ER and PR,the cells lining the lacunes were positive for CD34 and D2-40.The epitheliod cells were positive for HMB-45 and negative for Melan-A.The Ki-67 immunostaining showed a proliferation index of ＜ 1％.Conclusion LAM is an uncommon neoplastic multisystem disease that affects the lungs mostly.Endometrial endometrioid adenocarcinoma with LAM of pelvic lymph node is extremely rare.The diagnosis can be made according to the histological characteristics and immunohistochemical features.Moreover this conclusion will provide the clinicopathological materials for the future study about LAM.

Of 26 cases with pheochromocytoma which had been proved on operation,pathological examination was done in 21 cases.The authors analysed the cardiovascular complications in these patients and correlated them with the pathologic findings of the tumor.The results showed that patients with predominantly epinephrinesecreting tumors were prone to post-hypertesive hypotension,arrhythmia with rapid heart rate and catecholamine-induced myocardosis.Some illustrative examples were presented and path-ophysiology of these complications were discussed.

Glycosides are the active ingredients (AIs) of many Chinese herbs and have become hot spots along with the findings of their new functions,such as anti-inflammatory,antivirus,enhanced immunity and anti-cancer.It has been found that glycosides exert their effects by converting to aglycons or other AIs in vivo.Therefore,the transformation of glycosides to the corresponding AIs in vitro becomes very important to enhance their bioavailabilities.The microbial transformation has an unparalleled advantage in the transformation of Chinese herbs in vitro for its reaction specificity,less by-products,mild reaction conditions and environmental protection.This paper summarized and prospected researches of glycosides' microbial transformation.

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematically and legally inspecting and monitoring medical devices in use.
Equipment Safety ; Materials Management, Hospital

Objective To assess the efficacy of whole body diffusion weighted imaging (WB-DWI) in detecting pediatric primary and metastatic malignant tumor. Methods WB-DWI was performed in 62 healthy pediatric volunteers and 40 pediatric patients with confirmed malignant tumors. The healthy volunteers were divided into three groups: 0 to 12 months, more than 12 months to 5 years and more than 5 to 15 years. The characteristics of WB-DWI imaging were analyzed. McNemar test was used to compare the difference of detection on metastasis between WB-DWI and WB-DWI combined with MRI, CT. The mean apparent diffusion coefficient ( ADC ) values of primary tumors and metastases were measured by using paired t test and compared with those of corresponding body regions of control group. Results WB-DWI imaging shows that signal intensity of metaphysis gradually reduces with increasing age in the normal pediatric group. On WB-DWI primary malignant tumors showed 100％ (40/40) high signal intensity and metastases showed high signal intensity in 89.2％ (58/65) on WB-DWI, with a positive predictive value of 90. 6％ (58/64). The detecting rate for metastases increased to 95.4％ (62/65) when WB-DWI was combined with MRL/CT, with a positive predictive value of 95.4％ (62/65) there was no statistically significant difference ( x2 = 2. 25, P ＞ 0. 05 ). The ADC values of primary malignant tumor sites in head ( n = 5), liver(n=6), kidney(n=8), adrenal(n=ll) were (0.76 ±0. 19) ×10-3 , (0. 97 ±0.29) × 10-3,(0. 81 ±0. 12) × 10-3 and (0. 93 ±0. 28) × 10-3mm2/s and those of corresponding body regions of control group were (1.02 ±0. 11) × 10-3,(1.57 ±0.58) × 10-3, (1.19 ±0. 15) × 10-3 and (2.03 ±0.42) ×10-3mm2/s respectively, there were statistically significant difference( t values were 3.54,3. 84,7. 02 and 12. 57 ;P ＜ 0. 05 ). The A DC values of metastases sites in head ( n = 9 ), liver ( n = 13 ), kidney ( n = 17 ),bone(n =7) and lymph node(n =6) were (0. 88 ±0. 12) × 10-3, (0. 98 ±0. 10) × 10-3, (0. 89 ±0. 11 ) × 10-3, (0. 96 ±0. 15) × 10-3 and (0. 83 ±0. 14) × 10-3mm2/s, and those of corresponding body regions of control group were (1.01 ±0.09) × 10-3, (1.45 ±0.39) × 10-3, ( 1.31 ±0.27) × 10-3, ( 1.34 ±0. 20) × 10 -3 and ( 0. 99 ± 0. 08 ) × 10 -3 mm2/s, there were statistically significant difference ( t values 4. 09,45.50,6. 95,14. 00 and 9. 27 ;P ＜ 0. 05 ). Conclusions Increased signal intensity is more frequently observed in metaphysis of long bone in normal children on WB-DWI. With a high detection rate for primary and metastatic malignant tumors, WB-DWI combined with conventional CT; MRI can significantly improve their sensitivity.

Objective To compare the three kinds of methods for in vitro primary culturing of rheumatoid arthritis synovial fibroblast-like cells (RASFs), in order to get fast and effective culture methods. Methods Synovial tissue from RA synovial arthroscopic resection were treated by collagenase digestion method, modified tissue culture method, double enzyme digestion method respectively. By using an inverted phase contrast microscope, cell morphology and growth characteristics were observed and identified with vimentin staining. Trypan blue was used to count the number of living cells after culturing for 14d. Results The three primary methods could successfully isolate and culture RASFs, and RASFs met the morphological characteristics of vimentin-positive cells>95%, namely, the proportion of RASFs cell confluence was 70% after 16-20days by the collagenase digestion method,whose cell confluence proportion reached 95%after 4 weeks;and the cell confluence proportion was above 70%after 10-14days by modified tissue culture method,and the cell confluence proportion reached 85%after 4 weeks by the double enzyme digestion method. The comparison of the viable cells number cultured same number of synovial tissue by the three methods show the viable cells number cultured by the modified tissue culture method were (1.60±0.08) ×106, those by the collagenase digestion method were (1.41±0.08) ×106, those by the double enzyme digestion method were (1.19 ±0.05) ×106, which were with significant difference among them (P<0.05) .The comparison of incubation time of RASFs primary cells showed it took (267.50±16.58) mins by the collagenase digestion method, (183.75 ±11.08) mins by the double enzyme digestion method, and 149.10 ±13.71mins by the modified tissue culture method, with significant differences (P<0.05) .Conclusion Modified tissue culture for RASFs is an efficient and fast culture method, the number and purity of RASFs can meet the requirements for biology experiments.

Objective The clinical manifestations of cerebral infarction caused by acute basilar arterial occlusion are complex.The purpose of this study is to explore the relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Methods Fifty three patients diagnosed with cerebral infarction caused by acute artery occlusion were collected from Nanjing Stroke Registry.They were hospitalized in Jinling Hospital from January 2007 to July 2016 and were divided into sudden onset group and progressive onset group.Their clinical and digital subtraction angiography data were analyzed retrospectively.Results Middle and distal segment of the basilar artery occlusions were usually found in sudden onset group.Patients in progressive onset group were more likely to present with proximal segment of the basilar artery occlusions.Significant statistical difference was found between two groups (P<0.05).Logistic regression analysis showed that the symptoms of patients with proximal segment basilar artery occlusion tended to be progressive onset, compared with patients affected by distal segment occlusion (OR=14.77,95%CI:1.57-139.00, P=0.019).Conclusion There was significant relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Early diagnosis and timely treatment may improve clinical prognosis in patients.

Objective To study the targeting survivin small interfering RNA ( siRNA ) to inhibit proliferation and apoptosis survivin gene expression in rheumatoid arthritis synovial fibroblasts ( RASFs) .Methods RA patients were isolated and cultured in vitro synovial fibroblasts ( RASFs) , designed and synthesized siRNA targeting survivin and negative control, by liposome transfection RASFs cell; real-time quantitative polymerase chain reaction (PCR) and Western blot RASFs detect mRNA expression and protein levels of survivin.Tetrazolium blue (MTT) assay of cell proliferation;TUNEL assay apoptosis.Results The experimental group compared with the negative control siRNA group and control group, 48h after transfection of synovial fibroblasts survivin mRNA and protein expression levels were significantly decreased ( P<0.05 ) .The experimental group compared with the negative control siRNA group and control group, synovial fibroblast proliferation after transfection significantly decreased ( P<0.05 ) . After the experimental group transfected 24h, 48h, 72h growth inhibition rates were (11.5 ±2.6)%, (26.2 ±3.4)%, (47.6 ±4.1)%, at 72 hours after transfection most significant.The rate of apoptosis in experimental group (23.87 ±1.6)%, significantly higher than the negative control group (9.72 ± 1.15)% and the control group (8.70 ±1.09)% (all P<0.05).Conclusion siRNA targeting survivin expression levels through reducing survivin, inhibit synovial fibroblast proliferation and promotes apoptosis.