Objective: To understand the subjective and objective comfort evaluations of students from different age groups on desks and chairs, so as to provide reference for standardized allocation and use of desks and chairs. Methods: From January to April 2024, a total of 2 446 students were selected from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Wuxi from Jiangsu Province by using cluster random method, including students in kindergartens, primary schools, junior high schools,senior high schools, colleges and universities. Standardized procedures were used to measure the height and weight of participants, and the matching desks and chairs models were selected according to the height. The subjective comfort of students on matching desks and chairs was investigated, and their objective comfort was evaluated by using a self designed questionnaire. The χ 2 test was used to analyze the differences of subjective perception and objective evaluation in comfort between different types of desks and chairs. Results: About 84.1% of the students subjectively thought that large desks and small chairs were very comfortable or relatively comfortable, followed by large desks and chairs (75.7%), and the proportion of small desks and chairs was the lowest among the three types (46.2%), and the difference was statistically significant ( χ 2=722.46, P <0.01). The reporting rates of primary school, junior high school and senior high school students who subjectively considered large desks and chairs to be very comfortable/relatively comfortable were higher than that of other types of desks and chairs, and the differences were statistically significant ( χ 2=297.49, 252.82, 343.67, P <0.01). However, there was no significant difference in the subjective comfort evaluation of different types of desks and chairs among kindergarten children ( χ 2=3.21, P >0.05), and 66.3% of the students in colleges and universities felt very comfortable/relatively comfortable when they used the matching standard desks and chairs. The objective evaluation results of the comfort for the three types of desks and chairs were consistent with the subjective evaluation, but the proportions of the objective evaluation as very comfortable/relatively comfortable were higher than that of the subjective evaluation ( χ 2=20.76- 813.47, P <0.01). Conclusions Large desks and chairs, as well as large desks with small chairs are perceived comfortable, while small desks and chairs are perceived less comfortable. It is recommended to match the large desks and chairs or large desks and small chairs that are suitable for them according to the "standard", to promote physical and mental health of students.

Objective: To investigate the differences in the comfort of desks and chairs furniture among students with different body types according to the standard, so as to provide a reference for guiding students with overweight and obesity to choose the correct study furniture and revising the standards. Methods: From January to April 2024, 2 443 students from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Jiangsu Province were selected by the cluster random sampling method to conduct physical examination. The subjective and objective evaluations of the comfort of height matched desks and chairs were investigated. The students were divided into non overweight, overweight, and obesity groups according to relevant criteria, and stratified analysis was performed. The χ 2 test was used to analyze differences in the comfort evaluations of desks and chairs among students with different body types. Results: Among the 2 443 students surveyed, 16.7% and 12.6% were respectively classified as overweight and obese. All students assigned the highest comfort ratings to large desks and small chairs (84.1%), and consistency was observed between students subjective and objective evaluations. The reporting rate of samll desks and chairs of obesity students subjective evaluation was lower (36.8%) than that of overweight and non overweight/obesity students (52.1%, 48.0%) ( χ 2=14.63, P <0.01). The overweight and obese group of primary school students had a worse evaluation of the comfort of large desks and chairs and small desks and chairs than those of the non overweight and obese groups( χ 2=15.78, 7.63, P <0.05). Among high school students, the overweight and obese group had worse evaluation of the comfort of large desks and chairs, as well as large desks and small chairs, than those of the non-overweight and obese groups( χ 2=9.62, 11.77, P <0.05). The objective evaluations revealed low compliance ratings on the posture of the thighs and calves for naturally forming an angle greater than 90° (55.6%), and headroom height under the table (50.3%) with small desks and chairs ( χ 2=94.05, 166.47, P <0.05). Conclusions Compared with non overweight/obese students, students with overweight and obese students report poor comfort evaluations of height matched desks and chairs. Revision of the standard should consider the body types of students, and evaluations of the comfort of desks and chairs furniture by students with overweight and obesity should be improved.

Objective:To investigate the relationship between intracellular calcium level and neutrophil migration dysfunction in patients with sepsis.Methods:This study retrospectively collected 21 blood samples of patients with sepsis in the First Hospital of Jilin University from December 2017 to September 2018, and 20 healthy people were included as the control group. Peripheral blood neutrophils were isolated from the healthy controls and patients with sepsis using magnetic-activated cell sorting. Multichannel microfluidic microarray technology was used to detect the chemotactic migration of neutrophils. The levels of calcium in neutrophils from healthy controls and sepsis patients as well as in neutrophils from healthy controls that were pretreated with calcium chelators BAPTA-AM and EDTA were detected by flow cytometry using the calcium indicator Fluo-4.Results:The intracellular calcium levels were lower in neutrophils from sepsis patients than in those from healthy controls ( P<0.01). BAPTA-AM and EDTA could reduce the calcium level in neutrophils of healthy controls ( P<0.01). Microfluidics revealed that the migration speed, distance and gap-passing rate of neutrophils in microfluidics were significantly reduced after the decrease of intracellular calcium ( P<0.01). Conclusions:Reduced calcium levels in neutrophils of patients with sepsis may be closely related to the decreased cell migration. This study suggests that the migration impairment of neutrophils can be improved by regulating intracellular calcium levels, which provides a new idea for further research.

[Abstract] Objective: To explore the expression patterns of melanoma lineage antigens and nuclear antigen Ki-67 and their correlations with survival in melanoma patients. Methods: A retrospective analysis was conducted to analyze the pathological data of melanoma patients treated at the Department of Melanoma, Peking University Cancer Hospital from February 2008 to August 2020, mainly including the expression patterns of melanoma lineage antigens (S-100, HMB-45, Melan-A) and Ki-67, demographics, clinical features and survival. The correlation between expression patterns of melanoma lineage antigens, Ki-67 and melanoma-specific survival (MSS) was analyzed. Results: In total, 603 patients were included in this study. The median follow-up time was 47.4 months. The positive rates of S-100, HMB, and Melan-A were 92.8%, 92.1% and 90.0%, respectively. The percentages of patients with melanoma lineage antigen scores (S-100, HMB-45 and Melan-A was scored each, as 1 when positive and 0 when negative) of 0, 1, 2, and 3 were 0.5%, 5.0%, 15.6%, and 78.8%, respectively. The percentages of patients with Ki-67 scores of 0, 1, 2, and 3 were 43.0%, 36.3%, 16.3%, and 4.5%, respectively. Ki-67 was highly expressed in mucosal and progressive melanomas. In a multivariate analysis, Ki-67 expression was an independent prognostic factor for poorer MSS (HR=1.506, 95%CI: 1.248-1.818, P<0.001) as the incidence of MSS event increased by 50% per 25% increase in Ki-67 expression, whereas there was no statistical correlation between melanoma lineage antigen expression and MSS (HR=0.991, 95%CI: 0.759-1.293, P=0.94). Conclusion: High expressions melanoma lineage antigens are ubiquitous in melanoma tissues, and Ki-67 is an independent prognostic factor for MSS.

[Abstract] In the past, surgery and chemotherapy were the main treatment strategies for malignant melanoma, but companied with poor prognosis. With the development of high-throughput gene sequencing technology and the deepening understanding of tumor molecular mechanisms, it has been found that tumor heterogeneity and the diversity of tumor microenvironment affect tumor formation, drug resistance and treatment selection, leading to different responses and benefits of melanoma patients to the same treatment. The emerge and progression of targeted therapy and immunotherapy have significantly increased the survival rates of patients with metastatic melanoma, promoting the individualization and precision of melanoma treatment and making precise treatment a research hotspot as well as a trend. This review mainly summarizes the research progress of systemic individualized treatment of advanced melanoma based on precise subtyping and molecular level, and to get a more comprehensive view of the survival status of melanoma patients in the era of precision medicine, as well as the prospect and necessity of developing various targeted therapy, immunotherapy or combination therapy.

Objective:To explore the prognostic value of PD-L1 expression level in patients with metastatic renal cell carcinoma (mRCC).Methods:The clinicopathological and survival data of patients with mRCC in our hospital from Jan 2014 to Apr 2016 were retrospectively analyzed including 46 males and 15 females. The median age of these patients was 56 years(range: 29-75 years), with 41 patients ≤60 years and 20 patients >60 years. The baseline data before the systemic therapy showed 36 patients(59.0%)had 1 metastatic organ and 25 patients (41.0%) had equal or more than 2 organs to be metastasized. Among them, 17 patients(27.9%)had lung metastasis and 54 patients(88.5%)had liver metastasis. Abnormal baseline LDH occurred in 4 patients and 52 patients had normal LDH. Favorite and intermediate risk patients categorized by MSKCC risk stratification accounted for 59.6%(34 patients)and 40.4%(23 patients), respectively. Six patients(9.8%)experienced distant metastasis at initial diagnosis, with 4 of them undergoing primary site resection, and the other 55 patients undergoing radical nephrectomy. PD-L1 expression was detected by the immunohistochemical staining method. PD-L1 staining rate ≥1% detected on the tumor cell membrane was defined as positive expression. The correlation between PD-L1 expression and clinicopathological characteristics were compared. Kaplan-Meier method and log-rank test were used to compare the differences about DFS and OS under different factors. Cox proportional hazards regression model is used for multivariable analysis of survival data.Results:The detailed pathological types of the 61 patients with renal cell carcinoma were classified as 53 clear cell carcinomas, 3 papillary carcinomas, 1 collecting duct carcinoma, 2 translocation renal cell carcinomas and 2 being unclassified. There were 4, 20, 19 and 9 patients categorized as WHO/ISUP nuclear grade 1, 2, 3 and 4, and 26, 12, 20 and 2 patients were categorized as T 1, T 2, T 3 and T 4 stage, respectively. Five patients had regional lymph node metastasis(N+), and the other 56 patients had no regional lymph node metastasis(N-). The numbers of patients categorized as stage Ⅰ, Ⅱ, Ⅲ and Ⅳ diseases according to TNM staging system were 20, 11, 21 and 8, respectively. The total PD-L1 positive rate was 24.6%(15/61). The corresponding PD-L1 expression rate of patients with WHO/ISUP nuclear grade 1-4 were 0(0 patient), 5.0%(1 patient), 31.6%(6 patients)and 44.4%(4 patients), respectively; With the increasing WHO/ISUP nuclear grade, the positive rate of PD-L1 gradually escalated with a linear correlation ( P=0.006). The PD-L1 expression of the normal and abnormal LDH group were 19.2%(10 patients)and 75.0%(3 patients), respectively, with significant difference( P=0.035). Univariate analysis of disease-free survival time(DFS)showed that the prognostic factors include PD-L1( P=0.045), age group( P=0.014), WHO/ISUP nuclear grade( P<0.001), T stage( P=0.015), N stage( P=0.026)and TNM stage( P=0.005). However multivariate analysis only suggested WHO/ISUP nuclear grade as the independent prognostic factors for DFS( HR=1.8, 95% CI 1.1-2.9, P=0.018). Either in univariate or multivariate analysis, PD-L1 was not a prognostic factor for overall survival (OS)of mRCC patients(univariate analysis: P=0.154; multivariate analysis: P=0.902). The independent prognostic factors of OS include WHO/ISUP nuclear grade( HR=3.0, 95% CI 1.1-8.0, P=0.033)and MSKCC risk stratification( HR=5.9, 95% CI 1.2-29.7, P=0.03). Conclusions:This study showed that the higher the WHO/ISUP nuclear grade of patients with mRCC, the higher the positive rate of PD-L1. PD-L1 expression was not the independent prognostic factor for DFS or OS of mRCC.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Absdract Melanoma is characterized by high mortality and poor prognosis. The novel immunotherapy has offered a breakthrough in antitumor activity in melanoma and has offered incremental improvements over standard care. The ASCO annual meeting held on June 1, 2018 in Chicago, was conducted to present the progress of current treatment and promise of those still in clinical development. The academic event showed results of clinical trials in patients with lymph node dissection, adjuvant therapy, immunotherapy, and targeted therapy. Melanoma drugs introduced at the meeting included NIVO, Pembro, T-VEC, Encorafenib, Binimetinib, and CDk4/6i. The development of therapy is retrospected in this paper in order to provide a basis and give hope for melanoma treantment in China.

Objective To investigate the prenatal diagnosis and genetic counseling of fetal nuchal fold (NF) thickening.Methods This study retrospectively analyzed 17 fetuses with increased NF detected by prenatal ultrasound examination in Peking Union Medical College Hospital,Peking Union Medical College & Chinese Academy of Medical Sciences from December 1,2016 to December 1,2017.All cases were divided into isolated (isolated group) or non-isolated increased NF group (non-isolated group) according to whether the fetus had concomitant ultrasonographic abnormalities or not.Karyotype and chromosomal microarray analysis (CMA) were performed on all cases.Clinical data,prenatal genetic testing results and pregnancy outcomes were analyzed.Results Of those twelve cases in the isolated group,two were terminated due to the identification of chromosomal abnormalities and pathogenic copy number variations (CNVs) and the fetal autopsy results were consistent with the prenatal diagnosis.The rest 10 pregnancies were all continued including one fetus carrying a variant of unknown significance,which was proved to be a paternal heredity by CMA,and nine without genetic abnormalities and all-these infants were healthy during follow-up.Among the five non-isolated cases,one was diagnosed as trisomy 21 by karyotyping and CMA,and the other four were found to have structural abnormalities under ultrasound scan,but without genetic abnormalities in karyotyping and CMA.And all the five pregnancies were terminated after genetic counseling and three of them chose whole exome sequencing (WES) for further test.One homozygous mutation in CHRNA 1 gene and one de novo mutation in SETD2 gene were found in two cases,respectively,while no abnormality was identified in the other one case.Conclusions Once increased NF were indicated by ultrasound examination,prenatal genetic testing should be offered to the patients,including CMA,regardless of other ultrasonographic abnormalities,and WES should also be offered when necessary.Considering a thickened NF is associated with increased risks of structural defects,a close follow-up with fetal echocardiography and ultrasound is required even the prenatal tests are normal.

Objective: To investigate the effects of fluoride exposure on the thyroid hormone level and intelligence in rats and to investigate the biomarkers of intellectual impairment induced by high fluoride exposure. Methods: A total of 24 clean healthy Sprague-Dawley rats were randomly divided into control group (tap water containing 0.344 mg/L fluoride) and low-, medium-, and high-fluoride exposure groups (tap waters containing 10, 50, and 100 mg/L sodium fluoride, respectively). One male rat was cohabited with two female rats in the same group. After the offspring rats were weaned, 12 offspring rats (male/female ratio=1∶1) with a similar body weight in each group were subjected to the same treatment for the parental offspring. The offspring rats were sacrificed on the 60th day after birth. The weight of offspring rats was measured. Serum thyrotropin (TSH) , free triiodothyronine (FT₃) , and free thyroxine (FT₄) levels were measured by enzyme-linked immunosorbent assay. The learning and memory abilities of the rats were evaluated by Morris water maze test. The expression of mitochondrial fission 1 (Fis1) and mitofusin 1 (Mfn1) in blood was measured by Western blot. Results: The offspring rats in the medium-and high-fluoride exposure groups had significantly lower serum TSH and FT₄ levels than those in the control group (P<0.05). The place navigation test showed that the offspring rats in the medium-and high-fluoride exposure groups had significantly longer escape latency than those in the control group (P<0.05) , and the high-fluoride exposure group had a significantly longer escape distance than those in the control group (P<0.05). The spatial probe test showed that the offspring rats in the low-, medium-, and high-fluoride exposure groups had significantly shorter swimming time and distance in the target quadrant and total swimming time and distance than those in the control group (P<0.05). Compared with the offspring rats in the control group, those in the low-, medium-, and high-fluoride exposure groups had significantly higher expression of Fis1 (P<0.05) , and those in the low- and medium-fluoride exposure groups had significantly higher expression of Mfn1 (P<0.05) . Conclusion High fluoride exposure can reduce the secretion of thyroid hormone and the abnormality of mitochondrial dynamics in peripheral lymphocytes may provide a clue to identifying the biomarkers of intellectual impairment induced by fluoride exposure.