Objective To investigate the value of serum lactate dehydrogenase (LDH), β₂-microglobulin (β₂-MG) and serum ferritin (SF) combined with the modified WHO-based Prognostic Scoring System (WPSS) score in predicting poor prognosis of patients with myelodysplastic syndrome (MDS). Methods A total of 110 patients with MDS were selected as the research objects, and serum levels of LDH, β₂-MG and SF were detected. The patients were divided into death group and survival group according to their survival status, and the serum levels of LDH, β₂-MG and SF as well as the modified WPSS score were compared between the two groups. The risk factors for poor prognosis in MDS patients and the predictive values of serum LDH, β₂-MG, SF and modified WPSS score alone and their combination for poor prognosis in MDS patients were analyzed. Results The incidence of poor prognosis in MDS patients was 40.20% (41/102). The serum levels of LDH, β₂-MG and SF, the modified WPSS score, and the ratio of adverse karyotype prognosis in the death group were significantly higher than those in the survival group (P < 0.05). The results of Cox regression model analysis showed that elevated serum levels of LDH, β₂-MG and SF, elevated modified WPSS score, and adverse karyotype prognosis were risk factors for poor prognosis in MDS patients (P < 0.05). The results of receiver operating characteristic (ROC) curve analysis showed that the combination of serum LDH, β₂-MG, SF levels and modified WPSS score had a sensitivity of 95.12% and an area under the curve (AUC) of 0.918 for predicting poor prognosis in MDS patients, which were significantly higher than those of each indicator alone (P < 0.05). Conclusion Serum LDH, β₂-MG, SF levels and modified WPSS score have certain predictive value for poor prognosis in MDS patients, but the combined prediction value of the four indicators is higher.

Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.

Surgical resection and radiotherapy have been commonly applied to the treatment of early- and intermediate-stage Merkel cell carcinoma. In recent years, immunotherapy based on immunogenic characteristics of Merkel cell carcinoma has been proved to be effective in the treatment of advanced Merkel cell carcinoma. This review focuses on advances in the treatment of Merkel cell carcinoma, and provides a reference for its clinical diagnosis and treatment.

Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.

Kidney is a highly vascularized organ and peritubular capillary network constitutes the critical component of its microvascular system. Peritubular capillaries, as the main vessels for blood supply in renal tubules and renal interstitium, involve in important physiological processes in renal tubules such as energy metabolism, substance secretion and reabsorption. In recent years, it has been demonstrated that ischemia-reperfusion injury, rejection and renal fibrosis during kidney transplantation would result in compromised structural integrity and decreased number in peritubular capillaries, thus leading to interstitial fibrosis in renal allograft, which would seriously affect the long-term stability of renal function in the renal allograft. Therefore, we reviewed the structure and function of peritubular capillary, peritubular capillary and ischemia-reperfusion injury, rejection and renal allograft fibrosis, focusing on the mechanism for peritubular capillary injury in kidney transplantation and the specific changes manifested, with the aim of providing a reference for preventing and treating perioperative complications in kidney transplantation and improving the long-term prognosis of grafts.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Objective: To explore the correlation between blood pressure and urinary phthalandione, MMP, MEP, MnBP, MiBP, PAEs. Methods: Three schools were selected from Shenzhen, China for the present study. A total of 765 firstgrade students of Han ethnicity were recruited voluntarily from the selected schools during September 2016 to June 2017. They were divided into normal blood pressure (BP) group (lower than P90 group) and high BP group (BP≥P90). Linear and Logistic regression models were used to analyze the relationships between blood pressure and urine phthalate metabolite levels. Results: Urinary MMP and MnBP in students of high BP group were significantly higher than that of students in normal BP group(t=13.12, 3.97, P<0.05). Linear regression models showed that Z score increased when MMP and MnBP levels increased(P<0.05). Logistic regression model suggested that the risk of high BP increased with the increment of MMP level adjusting creatinine, sex, age and BMI(OR=1.47, P<0.05). There was no statistical significance in the differences after adjusting many factors including family income and education level of parents(P>0.05). Conclusion Urinary phthalate metabolite levels are positively associated with blood pressure in first-grade children.

BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P<0.05). During fol ow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P>0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.

BACKGROUND: Heme oxygenase-1 (HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. OBJECTIVE: To study HO-1 over-expression on the survival and fiver function of rats after reduced-size liver transplantation by constructing recombinant adenovims Ad5-HO-1.DESIGN, TIME AND SETTING: Randomized controlled animal study was performed in the Institute of Pediatrics, Children Hospital Affiliated to Chongqing Medical University from September 2003 to March 2005. MATERIALS: Seventy-four SD rats were used to establish in situ reduced-sized liver transplantation models. METHODS: Recombinant adenoviral vector encoding Ha-1 gene (AdS-HO-1) was generatred by molecular biology method, wluch was administered to donors via voln at 48 hours before transplantation. All rats were randomly divided into control group(n=12),saline group(n=12), cobalt protoporphyrin (CoPP)group(n=13),Ad5-HO-1 group(n=13),Ad5-green fluorescent protein(GFP)group(n=12),and Ad5-HO-1+zinc protoporphyrin (ZnPP)group (n=12).Livers of donor wefe harvested and stored for 24 hours at 4℃ in HTK solution. Before it is implantedinto recipient. MA IN OUTCOME MEASURES: Survival rate and liver function; portal vein blood flow monitored 2 hours after transplantation by Color Doppler How Imaging; pathological changes of transplanted liver tissue observed by HE staining;HO-1 activity, tumor necrosis factor-alpha(TNF-α),Bcl-2 and Bax expression detected by immunohistoehemical staining; changes of HO-1,TNF-α,bcl-2 and bax mRNA detected by molecular viewpoint. RESULTS: Survival rate in the Ad5-HO-1 group was significantly higher than that in the saline group at al,7,and 21 days after liver transplantation(P＜0.05).Glutamic pyruvic transaminase decreased in the Ad5-HO-1 group as compared to that in the saline,Ad5-GFP,and Ad5-HO-1+ZnPP groups(P＜0.05);portal venous blood flow significantly increased 2 hours after transplantation(P＜0.05);HO-1 activity also significantly increased(P＜0.05).RT-PCR and immunohistochemical staining showed that HO-1 and bcl-2 expressions increased(P＜0.05),but bax and TNF-αexpressions decreased(P＜0.05).CONCLUSION:Ad5-HO-1 significantly induces high expression of HO-1 increases portal venous blood flow within 2 hours alter liver transplantation, and promotes liver functional recovery so as to prolong survival time of rats after liver transplantion.