Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade malignant cutaneous tumor characterized by a high propensity for local recurrence, yet low rates of metastasis and mortality. The pathogenesis of DFSP is primarily associated with a chromosomal translocation t(17; 22)(q22; q13), which leads to the fusion of the platelet-derived growth factor subunit B gene with the collagen type I alpha 1 chain gene in the majority of cases. Diagnosis relies on histopathological examination, supported by imaging studies for comprehensive assessment. Surgical resection remains the cornerstone of treatment; however, it is frequently complicated by a high risk of local recurrence. Recent advances in radiotherapy and targeted therapeutic strategies offer promising avenues for reducing recurrence rates and improving patient survival. Nevertheless, the pathological heterogeneity and diverse clinical manifestations of DFSP pose considerable challenges to the development and implementation of individualized treatment approaches. Thus, further fundamental research and refinement of clinical management are imperative to advance the diagnosis and therapy of DFSP.

Objective To investigate a technical approach suitable for the clarification and concentration of Coxackievirus A16(CA16) harvest solution, aiming to effectively remove impurity particles and proteins while achieving high antigen concentration.Methods The virus harvest solution underwent two-stage filtration pretreatment. Antigen recovery rate,membrane flux, and turbidity were utilized as evaluation metrics at each stage to examine the effects of various membrane materials, pore sizes, and structures on clarifying efficacy. Subsequently, clarified harvest liquid was concentrated using a100 KD polyether sulfone membrane, and the changes in antigen content and protein content were analyzed to determine the optimal concentration multiples, washing cycles, and sampling intervals. The sample size was scaled up for pilot testing where the harvested liquid was clarified, filtered and subjected to ultrafiltration based on the optimized parameters. The linear scalability of this process was assessed using antigen recovery rates and protein removal rates as indicators.Results In the first stage, 0. 45 ??m glass fiber membranes were employed while in the second stage 0. 45 ??m polyether sulfone membranes were used. The optimal conditions for ultrafiltration concentration included a concentration factor ranging from 30 to50 times with four washing filtrations followed by four sampling collections. At pilot scale testing, post-clarification resulted in a turbidity reduction of CA16 virus by 96. 00%, with an antigen recovery rate of 89. 49%. Following ultrafiltration concentration yielded an antigen recovery rate of 87. 23% alongside a protein removal rate reaching 91. 17%.Conclusion The optimized ultrafiltration concentration technology not only reduces protein content but also achieves high levels of antigen recovery while demonstrating excellent potential for linear amplification.

Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade malignant cutaneous tumor characterized by a high propensity for local recurrence, yet low rates of metastasis and mortality. The pathogenesis of DFSP is primarily associated with a chromosomal translocation t(17; 22)(q22; q13), which leads to the fusion of the platelet-derived growth factor subunit B gene with the collagen type I alpha 1 chain gene in the majority of cases. Diagnosis relies on histopathological examination, supported by imaging studies for comprehensive assessment. Surgical resection remains the cornerstone of treatment; however, it is frequently complicated by a high risk of local recurrence. Recent advances in radiotherapy and targeted therapeutic strategies offer promising avenues for reducing recurrence rates and improving patient survival. Nevertheless, the pathological heterogeneity and diverse clinical manifestations of DFSP pose considerable challenges to the development and implementation of individualized treatment approaches. Thus, further fundamental research and refinement of clinical management are imperative to advance the diagnosis and therapy of DFSP.

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

Objective:To learn about the changes of the condition of coal-burning-borne endemic arsenism, the use of improved stoves and the formation of health-related behaviors in Shaanxi Province, and evaluate the effect of prevention and control measures.Methods:From 2015 to 2020, according to the "Implementation Plan for Monitoring Coal-burning-borne Endemic Arsenism in Shaanxi Province", regular field surveys were carried out in 4 natural villages, 2 counties in Ankang City and Hanzhong City, Shaanxi Province, to learn about the basic prevention and control situation in the monitoring village. Using the simple random sampling method, 10 families in each village were selected to investigate the use of stoves and the formation of health-related behaviors, and 5 of these families were selected to collect coal samples for arsenic content determination in accordance with the "Determination of Arsenic in Coal" (GB/T 3058-2008). According to the "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015), the condition of the people exposed to high arsenic coal in the monitoring village was investigated. Urine samples of 30 adult patients (half males and half females) with arsenic poisoning were collected, the content of arsenic in urine was determined by the "Urine-Determination of Arsenic-Silver Diethyldithiocarbamate-Triethanolamine-Spectrophotometric Method" (WS/T 28-1996).Results:A total of 240 households were monitored in the past 6 years, and the quality conformance and correct utilization rates of improved stoves in the households monitored in the disease areas remained at 100.00% in 2018 - 2020. The utilization rate of clean energy increased from 75.00% (30/40) in 2015 to 100.00% (40/40) in 2018 - 2020 (χ 2trend = 25.5, P < 0.001). The 73.75% (177/240) of households using a variety of clean energy. From 2018 to 2020, the correct drying, storage and pre-processing washing rates of corn and pepper continued to reach 100.00% (40/40). The arsenic content of coal ( n = 120) in the disease areas was (118.09 ± 57.91) mg/kg, ranging from 16.70 to 280.94 mg/kg. The detection rate of arsenic poisoning decreased from 6.34% (231/3 646) in 2015 to 2.90% (109/3 754) in 2020 (χ 2trend = 121.8, P < 0.001), and no skin cancer or Bowen's disease was detected. The geometric mean of arsenic content in urine ( n = 720) was 0.038 1 mg/L, ranging from 0.000 5 to 0.312 9 mg/L. Conclusions:The condition of coal-burning-borne endemic arsenism areas in Shaanxi Province has reached the national elimination standard. The quality and correct utilization rate of improved stoves and the rate of using clean energy have increased. The healthy-related behaviors the people in the endemic areas have been basically formed. The prevention and control work has achieved good results.

Objective:To explore any effect of training assisted by a pelvic rehabilitation robot on trunk control and walking after cerebral infarction.Methods:Forty cerebral infarction survivors with hemiplegia were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week, for 4 weeks. Before and after the intervention, the motor function, walking function, trunk control and pelvic movement were assessed using a simplified version of the Fugl-Meyer assessment (FMA-LL), functional ambulation categories (FAC) and the trunk control test (TCT).Results:After the treatment, significant improvement was observed in all of the above measurements in both groups. The average FMA-LL, FAC and TCT results of the experimental group as well as their average pelvic lateral displacement, height displacement, rotation angle and roll angle were all significantly superior to the control group′s averages.Conclusions:Robot-assisted training can effectively improve lower limb motor functioning, trunk control, walking and pelvic motion after cerebral infarction, with better curative effect than routine rehabilitation training alone.

Objective:To explore the effect of robot-assisted training and repetitive transcranial magnetic stimulation (rTMS) on the lower limb function of hemiplegic stroke survivors.Methods:Forty hemiplegic stroke patients were randomly divided into a treatment group ( n=20) and a control group ( n=20). Both groups were given routine rehabilitation training and robot-assisted walking training, but the treatment group was additionally treated with rTMS at 1Hz applied to the primary motor cortex M1 area at an intensity of 80% of the resting motor threshold. The stimulation time was 5 seconds at 5-second intervals, 600 pulses each time, five times a week for 8 weeks. Lower limb motor function, balance and walking function were assessed before and after the intervention using the Fugl-Meyer assessment for the lower extremities, the Berg balance scale and the Holden walking function scale. Results:There was no significant difference between the two groups in any measurement before the training, but after the intervention all of the measurements had improved significantly in both groups, with the average Fugl-Meyer score, Berg score and Holden grading significantly better in the treatment group.Conclusion:Repetitive transcranial magnetic stimulation can improve the effectiveness of robot-assisted walking training in improving lower limb motor function, balance and walking after a stroke.

Objective:To explore the effect of a pelvis-assisting rehabilitation robot on lower limb function and knee proprioception after cerebral infarction.Methods:Forty hemiplegic cerebral infarction survivors were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week for four weeks. Before and after the intervention, motor function, balance, walking function and knee joint proprioception were assessed using the simplified Fugl-Meyer lower limb assessment, the Berg balance scale, functional ambulation categorization and the Humac Norm isokinetic tester.Results:After the treatment, significant improvement was observed in all of the above measurements in both groups, but the improvements were significantly greater in the experimental group.Conclusions:Robotic pelvic assistance can effectively improve lower limb motor function, balance, knee proprioception and walking after cerebral infarction.

Objective To detect Mycobacterium tuberculosis (MTB)and its resistance against rifampin (RIF ) by applying Xpert MTB/RIF assay in the clinical samples from patients with extrapulmonary tuberculosis,and to discuss the value of this assay in extrapulmonary tuberculosis. Methods Totally 300 clinical samples from the patients who were highly suspected with extrapulmonary tuberculosis and hospitalized in Department of Tuberculosis Section,Shanghai Public Health Clinical Center of Fudan University from May 2014 to May 2015 were collected.Smear and fluorescence staining microscopy,MGIT 960 BACTEC liquid culture,Xpert MTB/RIF assay were applied to detect MTB in these samples.Meanwhile,all the patients received the peripheral blood T-cell spot of tuberculosis test (T-SPOT.TB).The sensitivity and specificity of Xpert MTB/RIF assay for MTB and its resistance against rifampin (RIF)in extrapulmonary tuberculosis samples were evaluated.The measurement data of two independent samples were analyzed by using t test and enumeration data were analyzed by usingχ2 test.Results Totally 282 out of 300 clinical samples from patients with extrapulmonary tuberculosis were included in this study,and 62.7% were male with average age of (32.1 ±24.6 )years and 37.3%were female with average age of (37.8 ±21 .0)years.When MGIT 960 BACTEC liquid culture results were considered as standard diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of Xpert MTB/RIF assay were 53.8% (95 %CI :37.4%—69.6%),100.0% (95 %CI :86.3%—100.0%),100.0% (95 %CI :80.8%—100.0%)and 63.3% (95 %CI :48.3%—76.2%), respectively.The sensitivity of Xpert MTB/RIF assay in smear-positive/culture-positive samples was 92.3% (95 %CI :62.1 %— 99.6%),while that in smear-negative/culture-positive samples was only 34.6% (95 %CI :17.9%— 55 .6%).Xpert MTB/RIF assay had advantage for detecting MTB in fine needle aspirates,pus,stool and urine,but not in serous effusion and cerebrospinal fluid.However,the sensitivities of MGIT BACTEC 960 liquid culture,fluorescence smear and T-SPOT.TB were 25 .8%, 21 .8% and 70.2%,respectively,and the specificities were 95 .5 %,90.3% and 51 .6%,respectively. The diagnostic value of Xpert MTB/RIF assay was not significantly different from those of MGIT BACTEC 960 liquid culture and fluorescence smear (χ2 =0.61 and 3.45 ,respectively;both P >0.05 ), while it was significantly different from T-SPOT.TB (χ2 =50.58,P <0.05).The sensitivity of T-SPOT. TB was significantly superior to Xpert MTB/RIF assay,but the specificity was relatively low.The sensitivity and specificity of Xpert MTB/RIF assay in RIF resistance detection were 71 .4% (95 %CI :30.3%—94.9%)and 100.0% (95 %CI :86.7%—100.0%),respectively.Conclusions The sensitivity and specificity of Xpert MTB/RIF assay in detecting MTB in fine needle aspirates,pus,stool and urine are relatively high,but not in serous effusion and cerebrospinal fluid.However,the pros of rapid detection and the ability of detecting RIF resistance are useful for the diagnose of extrapulmonary tuberculosis in clinical settings.

Objective To detect Mycobacterium tuberculosis (MTB) and rifampin resistance of the clinical specimens in children by Xpert MTB DNA and resistance to rifampicin (MTB/RIF) detection system,and evaluate the application value of this method in children with tuberculosis.Method Data of 109 children cases of clinically suspected tuberculosis were collected (including 46 gastric lavage aspirate,19 sputum,10 fine needle aspiration biopsy,4 pus,14 cerebrospinal fluid,11 Serous membrance fluid,1 marrow,3 stool,1 urine specimens)between April 2014 and March 2015.All specimens were detected by smear fluorescence staining microscopy,MGIT 960 BACTEC liquid culture,Xpert MTB/RIF assay and T-SPOT.TB test respectively.The sensitivity and specificity of Xpert MTB/RIF assay were analyzed in those clinical specimens.Result The sensitivity and specificity of the Xpert MTB/RIF assay for MTB detection in childhood tuberculosis clinical specimen were 28.6％ and 87.5％.The sensitivity of 65 pulmonary tuberculosis (46 gastric lavage aspirate,19 sputum) which included gastric lavage aspirates and sputum was 33.3％ and 57.1％,the specificity of the two was 100.0％.In 44 extrapulmonary tuberculosis,the sensitivity of the pus and the puncture fluid was higher and approached 100.0％.The detection rate of the cerebrospinal fluid and serous cavity effusion was very low.The sensitivity was 100.0％ in smear-positive and culture-positive samples and only 30.8％ to 50.0％ in smear-negative and culture-positive samples.The sensitivity and specificity of Xpert MTB/RIF assay to detect rifampin resistance were 100.0％.In clinical samples,the sensitivity of Xpert MTB/RIF assay was higher than that of smear fluorescence staining microscopy,but the difference was not statistically significant (X2 =0,P ＞ 0.05).The result was equivalent to that of MGIT 960 BACTEC liquid culture (28.6％ vs.27.3％,X2 =2.50,P ＞ 0.05),and far below that ofT-SPOT.TB(28.6％ vs59.7％,X2=13.92,P＜0.05).Conclusion Xpert MTB/RIF assay did not show obvious advantage in childhood tuberculosis,especially in serous cavity effusion and cerebrospinal fluid,but the advantages of detecting tuberculosis rapidly and resistance to rifampin can provide help for the clinical diagnosis and treatment in childrenhood tuberculosis.