Objective:To explore the effect of preoperative intensive functional training on the balance and functional recovery of patients with knee osteoarthritis (KOA) receiving total knee arthroplasty (TKA).Methods:Sixty KOA patients were randomly divided into an outpatient group, a home-based group and a control group, each of 20. Before their TKAs, both the outpatient and home-based groups underwent intensive functional training for 4 weeks, while the control group did nothing special. After the TKA, all received 4 weeks of standardized postoperative rehabilitation training. Before any training, after the 4 weeks of preoperative training and 4 weeks after the TKAs, all of the subjects performed the timed up and go test (TUGT), and their joint range of motion (ROM) was recorded. They also completed the 30-second chair stand strength test (30sCST), and the 6-minute walk exercise endurance test (6MWT). KOA osteoarthritis indices (WOMACs) were also recorded.Results:After the 4 weeks of preoperative training, significant differences were observed in the trajectory length, elliptical area and TUGT times of both the outpatient and home-based groups. Four weeks after the TKAs, significant differences were observed in all of the measurements in all three groups, but the results of the outpatient and home-based groups were significantly better than those of the control group, on average. After the 4 weeks of postoperative training, there were significant differences between the outpatient and home-based groups in terms of the average knee flexion angle, knee extension angle, 30sCST and 6MWT results. There were significant differences among the 3 groups in all of the measurements 4 weeks after the TKAs, with those of the two training groups showing significantly better results than the control group. The pain scores, stiffness scores, function scores and total WOMAC scores had improved significantly compared with the control group, but the average function and total WOMAC scores of the outpatient group (24.25±2.38) and (35.41±3.02) were then significantly superior to the home-based group′s averages.Conclusions:Intensive preoperative functional training conducted in an outpatient clinic or at home can significantly improve the balance, lower limb strength, exercise endurance and symptoms of KOA patients after TKA.

Objective:To investigate the effect of progressive resistance training on inflammatory markers, motor function and quality of life in the elderly after total knee arthroplasty (TKA).Methods:This study was a randomized controlled trial. A total of 46 elderly patients aged≥60 years who underwent total knee arthroplasty in the Affiliated Hospital 6 of Nantong University from January 2023 to June 2024 were selected and divided into experimental group and control group by computer random number method (23 cases in each group). The control group received routine rehabilitation management intervention, progressive resistance training was added to the experimental group on the basis of the control group, and all patients were intervened for 4 weeks. Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), 30-Second Chair Stand Test (30sCST), Knee Society Score (KSS), and World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) scores were measured at 1 day before operation, 2 weeks and 4 weeks after operation, and were compared respectively.Results:At 2 and 4 weeks after operation, the levels of IL-6 [(22.44±2.17) and (9.91±1.41) pg/ml], CRP[(19.61±2.20) and (3.17±0.40) mg/L] and ESR[(44.85±3.78) and (28.28±3.31) mm/1 h] in the experimental group were significantly lower than those in control group [IL-6: (24.65±1.77) and (11.35±1.67) pg/ml, CRP: (23.24±2.69) and (4.15±0.45) mg/L and ESR: (48.54±3.66) and (34.60±2.98) mm/1 h](all P<0.05). At 2 and 4 weeks after operation, the 30sCST[(9.87±0.92) and (11.83±1.03) times], clinical scores of KSS[(48.44±3.13) and (71.09±3.30) points], functional scores of KSS[(40.44±3.96) and (69.35±4.07) points] in the experimental group were significantly higher than those in control group [30sCST: (9.30±0.70) and (10.52±0.79) times, clinical scores of KSS: (46.17±2.86) and (67.00±2.89) points, functional scores of KSS: (38.91±3.68) and (66.30±5.05) points](all P<0.05). At 2 weeks after operation, the scores of physical health, mental health and social relations in the WHOQOL-BREF of the experimental group [(16.96±1.02), (17.96±1.46) and (6.74±0.62) points], which were significantly higher than those in the control group [(16.09±1.08), (17.14±1.12), (6.44±0.51) points](all P<0.05). There was no significant difference in the environmental condition score between the two groups. At 4 weeks after operation, the scores of physical health, mental health, social relations and environmental conditions in WHOQOL-BREF of the experimental group [(22.09±1.81), (22.17±2.19), (12.09±1.28) and (33.91±2.26) points] were significantly higher than those in the control group [(19.65±1.80), (20.39±1.95), (10.17±1.30), (31.96±2.51) points] (all P<0.05). Conclusion:Progressive resistance training can effectively reduce the inflammatory response in the elderly after total knee arthroplasty, enhance lower limb muscle strength and knee joint function, and improve the quality of life.

Objective:To explore the effect of preoperative intensive functional training on the balance and functional recovery of patients with knee osteoarthritis (KOA) receiving total knee arthroplasty (TKA).Methods:Sixty KOA patients were randomly divided into an outpatient group, a home-based group and a control group, each of 20. Before their TKAs, both the outpatient and home-based groups underwent intensive functional training for 4 weeks, while the control group did nothing special. After the TKA, all received 4 weeks of standardized postoperative rehabilitation training. Before any training, after the 4 weeks of preoperative training and 4 weeks after the TKAs, all of the subjects performed the timed up and go test (TUGT), and their joint range of motion (ROM) was recorded. They also completed the 30-second chair stand strength test (30sCST), and the 6-minute walk exercise endurance test (6MWT). KOA osteoarthritis indices (WOMACs) were also recorded.Results:After the 4 weeks of preoperative training, significant differences were observed in the trajectory length, elliptical area and TUGT times of both the outpatient and home-based groups. Four weeks after the TKAs, significant differences were observed in all of the measurements in all three groups, but the results of the outpatient and home-based groups were significantly better than those of the control group, on average. After the 4 weeks of postoperative training, there were significant differences between the outpatient and home-based groups in terms of the average knee flexion angle, knee extension angle, 30sCST and 6MWT results. There were significant differences among the 3 groups in all of the measurements 4 weeks after the TKAs, with those of the two training groups showing significantly better results than the control group. The pain scores, stiffness scores, function scores and total WOMAC scores had improved significantly compared with the control group, but the average function and total WOMAC scores of the outpatient group (24.25±2.38) and (35.41±3.02) were then significantly superior to the home-based group′s averages.Conclusions:Intensive preoperative functional training conducted in an outpatient clinic or at home can significantly improve the balance, lower limb strength, exercise endurance and symptoms of KOA patients after TKA.

Objective:To investigate the effect of progressive resistance training on inflammatory markers, motor function and quality of life in the elderly after total knee arthroplasty (TKA).Methods:This study was a randomized controlled trial. A total of 46 elderly patients aged≥60 years who underwent total knee arthroplasty in the Affiliated Hospital 6 of Nantong University from January 2023 to June 2024 were selected and divided into experimental group and control group by computer random number method (23 cases in each group). The control group received routine rehabilitation management intervention, progressive resistance training was added to the experimental group on the basis of the control group, and all patients were intervened for 4 weeks. Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), 30-Second Chair Stand Test (30sCST), Knee Society Score (KSS), and World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) scores were measured at 1 day before operation, 2 weeks and 4 weeks after operation, and were compared respectively.Results:At 2 and 4 weeks after operation, the levels of IL-6 [(22.44±2.17) and (9.91±1.41) pg/ml], CRP[(19.61±2.20) and (3.17±0.40) mg/L] and ESR[(44.85±3.78) and (28.28±3.31) mm/1 h] in the experimental group were significantly lower than those in control group [IL-6: (24.65±1.77) and (11.35±1.67) pg/ml, CRP: (23.24±2.69) and (4.15±0.45) mg/L and ESR: (48.54±3.66) and (34.60±2.98) mm/1 h](all P<0.05). At 2 and 4 weeks after operation, the 30sCST[(9.87±0.92) and (11.83±1.03) times], clinical scores of KSS[(48.44±3.13) and (71.09±3.30) points], functional scores of KSS[(40.44±3.96) and (69.35±4.07) points] in the experimental group were significantly higher than those in control group [30sCST: (9.30±0.70) and (10.52±0.79) times, clinical scores of KSS: (46.17±2.86) and (67.00±2.89) points, functional scores of KSS: (38.91±3.68) and (66.30±5.05) points](all P<0.05). At 2 weeks after operation, the scores of physical health, mental health and social relations in the WHOQOL-BREF of the experimental group [(16.96±1.02), (17.96±1.46) and (6.74±0.62) points], which were significantly higher than those in the control group [(16.09±1.08), (17.14±1.12), (6.44±0.51) points](all P<0.05). There was no significant difference in the environmental condition score between the two groups. At 4 weeks after operation, the scores of physical health, mental health, social relations and environmental conditions in WHOQOL-BREF of the experimental group [(22.09±1.81), (22.17±2.19), (12.09±1.28) and (33.91±2.26) points] were significantly higher than those in the control group [(19.65±1.80), (20.39±1.95), (10.17±1.30), (31.96±2.51) points] (all P<0.05). Conclusion:Progressive resistance training can effectively reduce the inflammatory response in the elderly after total knee arthroplasty, enhance lower limb muscle strength and knee joint function, and improve the quality of life.

Objective: To explore the relationship between serum 25-hydroxyvitamin D levels and core symptoms of autism spectrum disorder (ASD) in children. Method: In this cross-sectional study, ASD children 4 to 6 years of age who were diagnosed in Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin university from January to May 2017 were assigned to ASD group, and children for routine growth and development assessment in Jilin province were assigned to control group. The two groups were well matched for age and sex, and none of them had received vitamin D supplementation. Serum 25-hydroxyvitamin D levels were measured by HPLC-MS/MS method. The patients of the ASD group were assessed with autism behavior checklist (ABC), childhood autism rating scale (CARS), social response scale (SRS), and autism treatment evaluation checklist (ATEC). The levels of vitamin D were divided into normal(>0.03 ng/L), insufficient (0.01-0.03 ng/L) and deficient (<0.01 ng/L). Levels of serum vitamin D between the two groups were compared by two independent sample t-test, and the difference in the percentages of normal, insufficient and deficient levels of vitamin D was tested by chi-square test, and correlations between vitamin D levels and the total scores or subscales of ABC, CARS, SRS and ATEC were analyzed by Pearson correlation analysis. Result: The 87 subjects in the ASD group included 75 males and 12 females, with a mean (±SD) age of (4.7±0.7) years. The 301 subjects in the control group included 249 males and 52 females, with a mean (±SD) age of (4.8±0.8) years. Serum vitamin D level in ASD children was significantly lower than that of the control group ( (0.021±0.008) vs. (0.036±0.016) ng/L, t=-8.17, P<0.01), and the between-group percentage difference of normal, insufficient and deficient levels of vitamin D was statistically significant (12 (14%) vs. 186 (62%) , 67 (77%) vs. 113 (37%) , 8 (9%) vs. 2 (1%) , χ²=72.1, P<0.01). There were negative correlations between serum vitamin D level in ASD children and total ABC score or ABC subscale scores (body behavior, self-care, language and social interaction)(r=-0.531,-0.397,-0.283,-0.248,-0.262, P=0.000, 0.000, 0.007, 0.020, 0.014). There were negative correlations between serum vitamin D level in ASD children and total CARS score and CARS subscale scores (imitation, nonverbal communication and general impression) (r=-0.352, -0.216, -0.248, -0.216, P=0.001, 0.046, 0.021, 0.046). There were negative correlations between serum vitamin D level in ASD children and SRS behavior subscale or ATEC social interaction subscale (r=-0.536, P=0.005, r=-0.400, P=0.014). Conclusion Serum 25-hydroxyvitamin D level in children with ASD is obviously lower than that in the healthy control group, and there are negative correlations between vitamin D levels and core symptoms of ASD. Trial registration Chinese Clinical Trial Registry, ChiCTR-CCC-13004498.

Early and accurate diagnosis of hepatic fibrosis and application of antiviral therapy are the key to improving the prognosis of patients with chronic hepatitis B (CHB).Liver biopsy and transient elastography cannot be widely used for the diagnosis of hepatic fibrosis in clinical practice,and therefore,the serological diagnostic model has become a hot research topic in recent years.This article introduces a new serological diagnostic model,γ-glutamyl transpeptidase-to-platelet ratio (GPR),which has a high value in the diagnosis of hepatic fibrosis in CHB patients;however,the accuracy of GPR varies between different populations and different areas.GPR is also an excellent predictor for the prognosis of hepatitis B-associated liver cancer.It is pointed out that GPR has a promising future in the diagnosis of hepatic fibrosis in CHB patients,but due to a lack of clinical research data on GPR,further studies are needed to support its application in China.

Objective To compare the diagnostic values of γ-glutamyl transpeptidase-to-platelet ratio index (GPRI) ,aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fib-4) for chronic hepatitis B (CHB) fibrosis and cirrhosis .Methods According to the Metavir score ,262 CHB patients were divided into F0 — F1 group (n= 131) ,F2 — F3 group (n= 102) and F4 group (n = 29 ) . The age , gender , alanine aminotransferase (ALT ) , aspartate aminotransferase (AST ) ,γ-glutamyl transpeptidas (γ-GT ) and platelet count were recorded .GPRI ,APRI ,Fib-4 scores were calculated separately .Statistical analysis was performed by t test ,Kruskal-Wallis H test ,and χ2 test .The correlations between serum models and liver fibrosis stages were analyzed using the Spearman test .Results The scores of GPRI in F0 — F1 group ,F2 — F3 group and F4 group were 0 .39 (0 .21 , 0 .95) ,1 .05 (0 .38 ,2 .39) and 2 .11 (1 .12 ,3 .33) ,respectively .The difference was statistically significant (χ2 = 40 .645 ,P< 0 .01) .APRI scores in the three groups were 0 .49 (0 .32 ,0 .97) ,0 .77 (0 .52 ,1 .52) and 1 .12 (0 .77 ,2 .50) ,respectively .The difference was statistically significant (χ2 = 32 .636 , P < 0 .01) . Fib-4 scores in the three groups were 1 .36 (0 .92 ,2 .05) ,2 .34 (1 .28 ,4 .35) and 3 .86 (3 .03 ,8 .99) , respectively .The difference was statistically significant (χ2 = 48 .943 , P< 0 .01) .Age ,γ-GT ,AST and liver fibrosis were all positively correlated with liver fibrosis (r = 0 .322 ,0 .301 and 0 .199 ,respectively , all P< 0 .05) .Platelet was negatively correlated with liver fibrosis (r = — 0 .455 , P< 0 .05) ,while ALT was not significantly associated with hepatic fibrosis (r= 0 .111 ,P= 0 .073) .GPRI ,APRI and Fib-4 were positively correlated with liver fibrosis (r = 0 .625 ,0 .417 and 0 .399 ,respectively ,all P < 0 .05) .The areas under the operating characteristic curve of GPRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .818 ,0 .864 and 0 .837 ,respectively .APRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .694 ,0 .766 and 0 .722 ,respectively ,while Fib-4 were 0 .696 , 0 .770 and 0 .724 ,respectively .The low cutoff values of GPRI for various stages of liver fibrosis were 0 .99 ,1 .04 and 1 .06 ,respectively ,and the sensitivity ,specificity ,positive predictive value (PPV ) and negative predictive value (NPV) were all higher than those of APRI and Fib-4 .The high cutoff values of GPRI for liver fibrosis at each stage were 2 .49 ,3 .69 and 6 .77 , respectively , and the sensitivity , specificity ,PPV and NPV of the diagnosis were all higher than those of APRI and Fib-4 .Conclusion The diagnostic value of GPRI for CHB liver fibrosis is higher than those of APRI and Fib-4 .

Objective To explore therapeutic effects of hyperbaric oxygen (HBO) combined with nimustine (ACNU)on human glioma stem cells model,and analyze the related mechanism involved.Methods Balb/c nude mice were inoculated subcutaneously with human glioma stem cell line SU3,then were divided randomly into 4 groups,i.e.,the ACNU group,the HBO group,the ACNU + HBO group and the blank control group.The body weight and tumor volume of the tumor-bearing mice were measured regularly during the experiment.Unisense microelectrode was applied to detect oxygen level in tumor-bearing mice after HBO treatment.Upon completion of treatment,the tumor-beating mice were sacrificed and tumors were weighed.Histomorphological analyses of the transplanted tumors were also performed to analyze hypoxia,necrosis and expression levels of angiogenic related factors.Results Following HBO therapy,the oxygen level in the tumor tissue of the tumor-beating mice was significantly increased(P ＜ 0.01),and necrotic hemorrhage experienced a sharp decrease,when compared with the control group.The tumor weight of the ACNU + HBO group was the lowest(1.43 ± 0.38)g,and statistical differences could be seen,when compared with those of the other 3 groups(P ＜0.05.Tumor inhibition rates of the ACNU + HBO group,the ACNU group and the HBO group were respectively 76.29％,43.79％ and 31.51％.The expression levels of TNF-α,HIF-1α,NF-κB and VEGF and the density of inflammatory cell infiltration were negatively correlated with tumor inhibition rate.Conclusions HBO therapy could alter the hypoxic microenvironment in which tumor stem cells survive,and could also inhibit tumor cell proliferation and tumor-related inflammatory cell infiltration triggered by glioma stem cells to a certain extent.Besides,combined HBO therapy could improve the curative effect of ACNU,and reverse the hypoxia micro-environment of tumor stem cell niche via negative regulation on the expressions of NF-κB,HIF-1α,TNF-α and VEGF.

Objective To explore therapeutic effects of hyperbaric oxygen (HBO) combined with nimustine (ACNU)on human glioma stem cells model,and analyze the related mechanism involved.Methods Balb/c nude mice were inoculated subcutaneously with human glioma stem cell line SU3,then were divided randomly into 4 groups,i.e.,the ACNU group,the HBO group,the ACNU + HBO group and the blank control group.The body weight and tumor volume of the tumor-bearing mice were measured regularly during the experiment.Unisense microelectrode was applied to detect oxygen level in tumor-bearing mice after HBO treatment.Upon completion of treatment,the tumor-beating mice were sacrificed and tumors were weighed.Histomorphological analyses of the transplanted tumors were also performed to analyze hypoxia,necrosis and expression levels of angiogenic related factors.Results Following HBO therapy,the oxygen level in the tumor tissue of the tumor-beating mice was significantly increased(P ＜ 0.01),and necrotic hemorrhage experienced a sharp decrease,when compared with the control group.The tumor weight of the ACNU + HBO group was the lowest(1.43 ± 0.38)g,and statistical differences could be seen,when compared with those of the other 3 groups(P ＜0.05.Tumor inhibition rates of the ACNU + HBO group,the ACNU group and the HBO group were respectively 76.29％,43.79％ and 31.51％.The expression levels of TNF-α,HIF-1α,NF-κB and VEGF and the density of inflammatory cell infiltration were negatively correlated with tumor inhibition rate.Conclusions HBO therapy could alter the hypoxic microenvironment in which tumor stem cells survive,and could also inhibit tumor cell proliferation and tumor-related inflammatory cell infiltration triggered by glioma stem cells to a certain extent.Besides,combined HBO therapy could improve the curative effect of ACNU,and reverse the hypoxia micro-environment of tumor stem cell niche via negative regulation on the expressions of NF-κB,HIF-1α,TNF-α and VEGF.

Objective: To study the chemical components of Citrus medica L.var. sarcodactylis Swingle and to supply evidence for the quality control. Methods: Chromatography and recrystallization methods were applied to analyze the components. Results and Conclusion: Three compounds were extracted from Citrus medica L. var. sarcodactylis (Noot) Swingle. And their structures were identified as Limettin (I), stigmasta-5,22-dien-3-ol (II) and palmitic acid (III) by the methods of UV, MS, IR, 1HNMR, 13CNMR and DEPT. Stigmasta-5,22-dien-3-ol (II) was obtained by extraction.