AIM:To conduct the relevance analysis of serum Dickkopf-1 (Dkk-1) and bone mineral density (BMD) in the different ages of female populations.METHODS: The women volunteers (n=100, 20~80 years old) were selected and divided into young group (20~39 years old), middle age group (40~59 years old) and elderly group (60~80 years old).The serum levels of Dkk-1 in the 3 groups of volunteers were detected by ELISA.In the middle age group, 25 people of 45~55 years old were selected and divided into postmenopausal group and premenopausal group to de-tect the serum level of Dkk-1 in the 2 groups of volunteers by ELISA.The BMD was measured by the method of dual energy X-ray absorptiometry.The differences of Dkk-1 expression levels among different ages of female populations, and the rele-vance with BMD were compared.RESULTS:With the increase in age, the serum Dkk-1 expression level increased ( P<0.05), and BMD were reduced (P<0.05).The blood level of Dkk-1 and BMD negatively correlated (P<0.05) in the 3 groups of volunteers.The serum levels of Dkk-1 and BMD had stronger negative correlation in postmenopausal women group than that in premenopausal women group.CONCLUSION:With the increase in age, the expression level of serum Dkk-1 increases and the BMD level decreases, which contribute to a risk of osteoporosis.In the same age range, the postmeno-pausal women express higher level of Dkk-1, and the decreased BMD is more obvious, which contribute to a greater risk of osteoporosis.The increased level of Dkk-1 also inhibits bone formation and promotes bone resorption.It may become a new target for preventing and treating osteoporosis.

Objective · To assess the morphological changes of mitral valve geometry after mitral valve repair by using real-time 3D transesophageal echocardiography. Methods · The clinical data including 3D echocardiography of 36 patients undergoing mitral valve repair for mitral valve prolapse and 56 patients without mitral valve diseases were collected. Parameters of mitral annular and leaflet geometry were acquired and analyzed. Results · The ellipse index of the two-dimensional view (E2D), and non-planar leaflet angle (θNPA) were decreased, while other parameters were increased significantly in patients with mitral valve prolapse compared with controls before mitral valve repair. After repair, patients displayed larger θNPA, and still smaller E2D.Some parameters also get smaller, such as the anterior to posterior diameter of the mitral annulus, the anterolateral to posteromedial coaptation diameter,the minimum circumference of the three-dimensional view of the annulus, the minimum area of the two-dimensional view of the annulus, the exposed area of the anterior leaflet, inter-commissural diameter. Other parameters were not changed significantly. All parameters showed no significant difference between respect group and resect group in posterior valve prolapse before and after mitral valve repair. Conclusion · The repair procedure can restore the function of the mitral valve effectively. In view of the morphology, the geometry of the mitral valve annulus is still different from the normal apparently after the mitral valve repair, but the normal morphology of the leaflets can be regained. It seems to have similar curative effect morphologically for patients with posterior leaflet prolapse to have respect or resect strategy.

BACKGROUND:No studies currently focus on the measurement of daily water loss under certain physical activity level continuously and precisely.
OBJECTIVE:To provide evidence for daily water requirement in Chinese young men based on the measurement of the daily water loss in Chinese young men under moderate physical activity.
METHODS:Twenty male subjects were enroled, and 23-hour whole-body sweat loss and urine output were measured using high-precision body weighting scale in whole-room indirect calorimeter. The results were converted to daily (24-hour) water requirement to determine the daily water requirement. Daily whole-body sweat loss per unit body weight, daily whole-body sweat loss per unit fat free mass and daily whole-body sweat loss per unit surface area were calculated.
RESULTS AND CONCLUSION:In Chinese young men, daily water loss was (3 339.7±509.9) g, daily urine output was (1 982.9±449.5) g and daily whole-body sweat loss was (1 356.7±215.6) g. There was a linear correlation between water intake and water loss (r=0.616,P < 0.05). Daily whole-body sweat loss per unit body weight was (21.0±3.6) g/kg, daily whole-body sweat loss per unit fat free mass was (25.8±3.9) g/kg and daily whole-body sweat loss per unit surface area was (799.4±129.4) g/m2. Daily water requirement of Chinese young men under moderate physical activity is approximately 3 340g, and moreover, water loss increases with the increase of water intake.

Objective:To construct double-layered controlled release system containing SDF-1 and rhBMP-2 molecules and to study the release profile of the system in vitro.Methods:The polylactic acid/chitosan(PLA/CS)nanoparticles were prepared with “emulsification-solution evaporation method”,the preparation parameters were determined by orthogonal test design.The particle size was observed by nanoparticle size analyzer,the morphology of the nanoparticles was observed with electron microscope.Then rhBMP-2 and SDF-1 were loaded into the nanoparticles in the process of emulsification,the loading efficiency and encapsulation efficiency were calculated and in vitro release was observed.Results:The double-layer nanoparticles showed spherical geometry,smooth surface and complete separation. The average particle size of the nanoparticles was (542.33 ±14.38)nm;The drug loading and incorporation efficiency of rhBMP-2 were (82.41 ±1.05)% and (24.67 ±0.43)ng/mg,those of rhBMP-2 were (75.58 ±0.84)% and (22.63 ±0.41)ng/mg,respectively. The release time of the drug from the system sustained over at least 30 days,the release profile of both drugs showed “biphasic release”. The cumulative release rate of SDF-1 and rhBMP-2 was 72.85% and 91.01% in 30 days respectively.Conclusion:The SDF-1 and rh-BMP-2 loaded PLA/CS nanoparticles have excellent morphology,high entrapment and good sustained-release in vitro.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

Objective: To investigate the application of rope band therapy training on lower extremity motion function of children with spastic cerebral palsy. Methods: A total of 55 children with spastic cerebral palsy were admitted to the Second Hospital Affiliated to Guangxi Medical University from January 2017 to March 2018, 27 males and 28 females, and the average age was(51.2±1.7)months.They were divided into a regular group (28 cases) and a rope band therapy training group (27 cases) according to random number table.The regular group included 14 males and 14 females, aged 2 to 6 years old, the mean age was (51.3±1.8) months; the rope therapy training group included 13 males and 14 females, aged 2 to 6 years old, the mean age was (51.1±1.9) months.The regular group was only treated by routine rehabilitation training.On the basis of routine rehabilitation training, the rope therapy training group also underwent the rope therapy training.Before and after 12 weeks of treatment, the 2 groups of children were evaluated and compared by Ashworth improved rating scale (MAS), children balance scale (PBS) and gross motor function test scale(GMFM-88 D and E regions). Results: After 12 weeks of treatment, the MAS score of the regular group was (2.64±1.63) scores, the PBS score was (25.44±9.71) scores, the GMFM score of D regions score was (23.82±3.61) scores and E regions score was (26.34±8.81) scores. The MAS score of the rope therapy training group was (2.11±8.75) scores, the PBS (31.92±6.84) scores, the GMFM score of D region was (27.75±6.81) scores, and E region (31.92±6.84) scores.All evaluation criteria of 2 groups of children were improved than those before treatment (all P<0.05). However, the scores of the rope therapy training group were significantly better than those of the regular group, and the difference was significant (t=4.144, 5.186, 3.769, 4.254, all P<0.05). Conclusions Rope therapy training can effectively improve lower extremity motion function of children with spastic cerebral palsy, the gross motor function, spastic level and balance ability.

Objective: To probe into the correlation between chronic liver disease and intestinal barrier function. Methods: 1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients’ intestinal barrier function like diamine oxidase (DAO), D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett’s test, χ ² test of fourfold table, Pearson’s correlation, and binary logistic regression. Results: The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% (379/741) vs. 18.53% (139/750), χ ² = 193.58, P < 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier function in chronic liver disease group showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes (P < 0.05 ). GGT had stimulated DAO (P < 0.05, OR > 1), D-lactate (P < 0.05, OR > 1), lipopolysaccharide (P < 0.05, OR > 1), ALT and AST. Conclusion Chronic liver disease increases with damage to intestinal barrier function.

There are many kinds of variabilities of fetal venous system tending to complicated with complex cardiovascular malformations.Prenatal ultrasound is of great importance for evaluation of fetal venous system.High-definition flow(HD-Flow)combined with spatiotemporal image correlation(STIC)could not only display micro blood flow in fetal venous system,but also show the spatial alignment and flow direction in real time.The research progresses of HD-Flow combined with STIC for evaluating fetal venous system abnormalities were reviewed in this article.

Objective:To explore the morbidity features and therapeutic outcomes of rejections in pediatric kidney transplantation (KT) recipients.Methods:Between January 2013 and June 2022, 360 children undergoing KT were recruited.The relevant clinical data were collected for examining the morbidity features and therapeutic outcomes of rejections.The serum levels of creatinine were compared among groups by non-parametric rank test.And Kaplan-Meier and Log-rank methods were employed for examining the incidence of rejection and comparing mortality-censored graft survival rates among patients with different times of rejection.Results:A total of 58 recipients had 82 incidents of rejection with a cumulative incidence of 6.3%, 9.2% and 11.3% at 3/6/12 months respectively.Among 50 incidents of biopsy-proved rejections, the types were T cell-mediated rejection [TCMR, 42.0%(21/50)], antibody-mediated rejection [20.0%(10/50), ABMR] and mixed rejection [38.0%(19/50)].Among 58 incidents of initial rejection, 69% had maintained graft function (MGF) and 31% impaired graft function (IGF) after anti-rejection regimens.Among 80.8%, 85.7% and 75% of recipients with clinical rejection, ABMR or borderline rejection while 36.4% in TCMR patients had MGF.Fifteen kidney allografts lost function in 58 recipients with rejection.Five-year death-censored graft survival was significantly lower in patients with two or more incidents of rejection (30.5%, 95% CI: 12.3%-75.4%) than in those without rejection (92.9%, 95% CI: 89.3%-96.6%) ( P<0.000 1) or with only one rejection (82.9%, 95% CI: 65.9%-100%)( P<0.001). Conclusions:The rejection rate remains high in KT children and it affects graft survival.And TCMR is more likely to cause impaired graft function.Recurrent rejections have a more pronounced impact upon graft survival.

OBJECTIVETo analyze early hematopoietic response and long-term survival of very severe aplastic anemia (VSAA) patients with different absolute neutrophil counts (ANC) after frontline immnunosuppressive therapy (IST).

METHODSClinical data and outcome of 145 VSAA patients treated with rabbit antithymocyte globulin combined with cyclosporine were retrospectively analyzed. Hematopoietic responses to IST and long-term survival were statistically analyzed for VSAA patients in different ANC subgroups.

RESULTSPre-IST ANC=0.05×10(9)/L acted as the best cutoff level to predict IST response at 3, 6 months. For 145 VSAA patients, early death rate was 13.4% (11/82) vs 1.6% (1/63), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group (P<0.05). Hematopoietic response rates to IST was 22.0% vs 54.0% (P=0.000) at 3 months, 34.1% vs 63.5% (P=0.000) at 6 months; the overall five-year survival rate was only (62.5±5.4) % vs (91.4±3.7) % (P=0.000) and five-year event-free survival rate was (42.3±5.5) % vs (63.1±6.5) % (P=0.003), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group.

CONCLUSIONVSAA patients with extremely low ANC (≤0.05×10(9)/L) had high early death rate and with very low response rate to frontline IST and poor survival, so it is urgent to seek for the alternative frontline therapy that will bring faster and better outcome for these patients.

Anemia, Aplastic ; blood ; drug therapy ; Animals ; Antilymphocyte Serum ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukocyte Count ; Neutrophils ; cytology ; Rabbits ; Retrospective Studies ; Survival Rate ; Treatment Outcome