To investigate the bone health status and potential influencing factors of bone mineral density in adult patients with hemophilia, providing a reference for improving their bone health and for the prevention, treatment, and rehabilitation intervention of osteoporosis.

Objective:To explore the level of physical activity of Chinese adults with haemophilia and its related factors so as to provide a reference for their comprehensive management.Methods:The daily physical activity of adults with haemophilia was surveyed using the International Physical Activity Questionnaire (IPAQ). A total of 110 questionnaires were eligible for analysis at last. The results were compared with published data from other societies using independent sample t-tests and chi squared tests. Spearman correlation analysis and multivariate logistic regression analysis were applied to explore factors related to the subjects′ physical activity levels.Results:Fully 30.9% of the subjects claimed to maintain a high level of physical activity. This was significantly different from the distribution of physical activity observed in Japan (12.4%), Ireland (50.9%) and the United Kingdom (43.1%). According to the Spearman correlation analysis, the number of joints affected, anxiety, and depression are all significantly related to the level of physical activity among such adults. Multivariate logistic regression analysis showed that depression was an independent factor affecting the patients′ level of physical activities.Conclusion:Chinese and Japanese adults with hemophilia have relatively low levels of physical activity, possibly influenced by depression.

Objective:To determine the minimum clinically-important difference (MCID) in the rehabilitation effect among children with haemophilic knee joint contracture.Methods:The data describing 28 children with an average age of 13.89±3.00 years and haemophilic knee joint contracture who received no less than 10 sessions of physiotherapy in the Department of Rehabilitation Medicine at the Peking Union Medical College Hospital were analyzed. The therapeutic effect of the treatement was quantified in terms of Haemophilia Joint Health Scores (HJHSs) for their knees. The MCID after the therapy was evaluated using the mean change method, multivariate linear regression, receiver operating characteristics, and the distribution-based method.Results:The MCID for the improvement of knee HJHS was 5.13 by the mean change method, 4.31 by multivariate linear regression, 3.50 according to the ROC curve and 1.64 by the distribution-based method. Taking all of them into consideration, 4.31 was found to be an appropriate value.Conclusions:The MCID after physical therapy for the improvement in knee HJHS for a child with haemophilic knee contracture is 4.31. Improvements greater than 4.31 can be considered clinically significant.

Objective:To explore the international research hotpots and development trend of therapeutic drug monitoring (TDM).Methods:Web of Science database was searched as of February 16, 2022, with search term of "therapeutic drug monitoring" or "drug monitoring". The research articles on TDM were collected and analyzed for the annual publication amount, countries, authors, and institutions. Citation burst was detected using CiteSpace software, and keywords-cluster was carried out by VOSviewer to visually show the research hotpots.Results:A total of 2 318 articles were included, and the first one was published in 1975. The United States published the largest amount of related articles and had the closest cooperation with other countries. University of Queensland in Australia was the institution with the most publications, and Roberts JA was the author with the most publications. A total of 10 citation bursts were detected, and 6 keywords-clusters related to TDM were found by cluster analysis method. Recent international research hotspots included TDM of biologics in patients with inflammatory bowel disease, TDM of anti-infective drugs in critically ill patients, and TDM of anti-tumor drugs.Conclusions:Referring to the international research hotspots, TDM should be carried out for more drugs, such as infliximab, adalimumab, and imatinib, etc., to provide personalized and precise medication care for patients and improve the safety of drug therapy.

Objective:To explore the international research hotpots and development trend of therapeutic drug monitoring (TDM).Methods:Web of Science database was searched as of February 16, 2022, with search term of "therapeutic drug monitoring" or "drug monitoring". The research articles on TDM were collected and analyzed for the annual publication amount, countries, authors, and institutions. Citation burst was detected using CiteSpace software, and keywords-cluster was carried out by VOSviewer to visually show the research hotpots.Results:A total of 2 318 articles were included, and the first one was published in 1975. The United States published the largest amount of related articles and had the closest cooperation with other countries. University of Queensland in Australia was the institution with the most publications, and Roberts JA was the author with the most publications. A total of 10 citation bursts were detected, and 6 keywords-clusters related to TDM were found by cluster analysis method. Recent international research hotspots included TDM of biologics in patients with inflammatory bowel disease, TDM of anti-infective drugs in critically ill patients, and TDM of anti-tumor drugs.Conclusions:Referring to the international research hotspots, TDM should be carried out for more drugs, such as infliximab, adalimumab, and imatinib, etc., to provide personalized and precise medication care for patients and improve the safety of drug therapy.

Objective:To investigate the effectiveness of scanning glucose monitoring system in dawn phenomenon of patients with type 2 diabetes mellitus (T2DM) based on continuous glucose monitoring system (CGMS) .Methods:A total of 45 patients with T2DM hospitalized in the Endocrine Department of Xinxiang Central Hospital from June 2019 to June 2020 were selected as the research subjects by convenience sampling method. All selected patients were asked to wear the scanning glucose monitoring system after admission, and then the CGMS for continuous glucose monitoring after 48 hours. The scanning glucose monitoring system and the CGMS were taken off at the same time after 72 hours. The blood glucose analysis report of the same period was checked to determine whether the dawn phenomenon occurred. The consistency to determine dawn phenomenon was analyzed between CGMS and scanning blood glucose monitoring by Kappa test. According to the CGMS judgment results, the receiver operating characteristic curve (ROC) of the scanning blood glucose monitoring system was drawn to evaluate the optimal tangent value of the night blood glucose for predicting dawn phenomenon and the next day fasting blood glucose for evaluating dawn phenomenon.Results:Among the 45 study subjects, there was no statistical difference in determining the incidence of dawn phenomena between CGMS and scanning glucose monitoring system [55.56% (25/45) vs. 46.67% (21/45) , χ 2=0.711, P>0.05]. Consistency analysis showed that Kappa value was 0.895, and the consistency of CGMS and scanning glucose monitoring system in judging dawn phenomenon was good (Kappa=0.895, 95% CI 1.130-4.883, P<0.01) . The optimal tangent value of night blood glucose for predicting dawn phenomenon was 8.31 mmol/L, and the optimal tangent value of the next day fasting blood glucose for evaluating dawn phenomenon was 7.25 mmol/L. The value of the area under the ROC curve were 0.729 and 0.803 respectively. Conclusions:Scanning blood glucose monitoring can accurately judge the dawn phenomenon. When the night blood glucose value is 8.31 mmol/L, it indicates that the dawn phenomenon may occur. When the next day's fasting blood glucose value is 7.25 mmol/L, it indicates that the dawn phenomenon may already occur.

Objective: Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease.The current domestic reports of EoE in children is rare.The aim of this study was to analyze the clinical features, the diagnosis and treatment advance of EoE in children by case analysis and literature review. Method: Clinical data of 22 children with EoE from January, 2011 to December, 2015 in Children′s Hospital, Zhejiang University School of Medicine were recorded, retrospective analysis was performed on clinical presentation, gastroendoscopy and histopathological examination features and the treatment. Result: (1) Clinical data: EoE can occur at any age in children (5 months to 13 years). The most common clinical manifestations of EoE are vomiting and abdominal pain, 45% (10/22) and 41%(9/22) respectively. (2) Endoscopy and pathological features of esophageal mucosa: 11 cases with coarse mucous membrane (50%), 6 cases with congestion or erosion of esophageal membrane (27%), 5 cases with longitudinal crack (23%), 3 cases with ring uplift (14%), 3 cases with granular uplift (14%), 3 cases with normal mucosa(14%). Histopathologic manifestation is eosinophil infiltration and the eosinophil counts were all more than or equal to 15/HP. (3) Laboratory results: 13 cases had increasing eosinophil counts and eosinophils proportion (62%). (4)Allergy history: among 22 cases, 7 patients had allergy history (32%). (5) Situation of treatment and remission: 16 cases had clinical remission by oral omeprazole; 2 cases had clinical remission by oral Omeprazole and Montelukast sodium; 1 case acquired remission by elimination diet; 1 case acquired remission by elimination diet and oral prednisone. 2 cases dropped out; Only 2 patients received gastroendoscopy re-examination after 3 months and revealed esophageal mucosal histologic complete recovery. Conclusion The clinical symptoms of EoE in children varies.Esophageal mucosal features of gastroendoscopy examination in children with EoE were longitudinal crack, white exudates or plaques, paper mucosa, ring uplift and granular uplift.Most patients could achieve remission by using proton-pump inhibitors, only few children needed elimination diet and change formula, or even oral glucocorticoids.