Objective:To explore the utility of a robotic trunk support brace (a RoboBDsys) in evaluating seated trunk control after a spinal cord injury (SCI).Methods:Twenty wheelchair-dependent SCI patients were tested for trunk resistance while seated and wearing the RoboBDsys. In the test they were required to maintain an upright seated position for 1 minute while external forces were applied from the left, right, anterior and posterior directions. The system generated eight observations of swings of the center of pressure (COP), their mean velocity and their standard deviations. Sway area, sway path (SP), mean sway frequency (MF) and mean sway amplitude (MA) were also recorded along with the maximum voluntary contraction torque (MVC). The trunk control test (TCT), the Tinetti Balance Scale (Tinetti), the modified Functional Reach Test (mFRT) and Spinal Cord Independence Measure III (SCIM-III) were also administerd and their results were correlated with the RoboBDsys resistance test results.Results:All twenty of the patients completed the resistance test in the left and right directions, but only 11 did it in the anterior and posterior directions. In the left and right-direction resistance tests the average center of pressure deviation, sway area and MVC showed some significant correlation with the TCT, Tinetti, mFRT and SCIM-III results (| r| ranging from 0.46 to 0.74). The average MVC in the anterior-direction correlated moderately with the TCT, mFRT and SCIM-III results (| r|=0.63 to 0.67), while that in the posterior-direction had moderate correlation with the TCT and mFRT results only (| r|=0.63 to 0.67). Conclusion:The Robotic Brace for Dynamic Trunk Support system can be effective in assessing reactive postural control and functional independence after a spinal cord injury.

Purpose/Significance To analyze the dynamic changes,influencing factors and weak links of e-health literacy of middle-aged and elderly people,so as to provide references for improving e-health literacy of middle-aged and elderly people.Method/Process A questionnaire survey is conducted among 505 middle-aged and elderly people in Guangzhou,and the results are analyzed by using SPSS 24.0.Result/Conclusion The average score of e-health literacy of middle-aged and elderly people is in the middle level;The weak link of e-health literacy is the lack of health information interaction and evaluation capacity.Individual factors are the primary factors that affect e-health literacy of middle-aged and elderly people.It is suggested to increase policy and financial support,carry out"the younger population helps the aging population"mode,and elderly-oriented transformation of digital health Apps.

Purpose/Significance Disease description texts are analyzed to reach a deeper understanding of the current status of on-line consultations for sleep disorders and the thematic characteristics of users with sleep disorders.Method/Process Data about sleep dis-orders from"haodf.com"website is collected by using a web crawler.Furthermore,the main themes about patients'description are i-dentified by the latent Dirichlet allocation(LDA)model.Result/Conclusion The departments of sleep disorders are more dispersed,and the main treatment is drug therapy.Online consultations could improve 83.2％of patients'condition.The themes of patients's disease descriptions include medication and consultation,external environment,description of symptoms,surrogate questions and causes.It is suggested that the platform and doctors should pay attention to the prognosis of patients'medication and mental health status,and pay at-tention to the popularization of comorbidities.

OBJECTIVE To provide reference for the regulation of electronic prescription circulation under the mode of “medical science + pharmacy”. METHODS Based on evolutionary game theory， a tripartite evolutionary game model was constructed for related parties of electronic prescription circulation （government agencies， internet hospitals and third-party drug platforms） under the mode of “medical science + pharmacy”. The influential factors of the three parties’ strategy selection were analyzed and verified by simulation. RESULTS & CONCLUSIONS The strategic choices of all parties in the game were affected by the other two parties. Reducing the cost of strict supervision or increasing the punishment for the other two parties would increase the probability of strict supervision of government agencies. Enhancing reputation losses， increasing penalties， and reducing the cost difference when choosing different strategies would have regulatory and binding effects on internet hospitals and third-party drug platforms. It is suggested that government agencies can introduce diversified supervision mode and establish an integrated “intelligent supervision + traceability” system； pay attention to the construction of reputation mechanism， and promote the coordinated linkage of all parties； increase the punishment for violations， provide policy support， reduce the cost of compliance behavior to promote the high-quality development of electronic prescription circulation under the mode of “medical science + pharmacy”.

Objective:To investigate the test-retest reliability and criterion validity of the Robotic Brace for Dynamic Trunk Support System(RoboBDsys)in evaluating seated trunk control function in patients with spinal cord in-jury(SCI). Method:From October to December,2022,20 patients with spinal cord injury who were unable to walk were recruited.All participants completed RoboBDsys trunk control test including static control test and dynam-ic control test on the seated platform.The evaluation indexes were the supporting torque regression slope exert-ed by the robot platform on the direction of x,y,α,and θ,recorded as Kx,Ky,Kθ,Kα;the average sup-porting torque recorded as Fx,Fy,Mθ,Mα in the static control test;and the the Range of Motion(ROM)of trunk in four directions in the dynamic control test.All the participants completed Trunk Control Test(TCT)as criterion assessment.The test interval was one week,intraclass correlation coefficient(ICC)values were calculated between two RoboBDsys trunk control test. Result:There were 13 participants completed two tests.In the static control test,the ICCs of four indexes were 0.418-0.742 between 2 tests;the ICCs of all indexes in dynamic control test were 0.633-0.848,which all showed moderate to high test-retest reliability.In regards of criterion validity,there was low to mod-erate correlation between Ky,Mθ,Mα in static control test and TCT(|r|=0.467-0.561,P＜0.05);all indexes except right lateral flection ROM in dynamic control test showed moderate to high correlation with TCT(r=0.559-0.758,P＜0.05). Conclusion:RoboBDsys is a reliable and valid tool for evaluating seated trunk control function in patients with SCI.

Surgical treatment for bone and soft tumors of pelvis and sacrum presents a big challenge, because of the complex anatomy of sacropelvic region, large tumor volume at presentation, rich blood supply to the tumor and visceral involvemen, et al. Therefore, surgical excision and reconstruction are technically difficult for sacropelvic tumors. Extensive intraoperative haemorrhage could be life-threatening, and this issue remains a major concern. How to effectively control bleeding during surgery is critical for successful operation and patient's favorable prognosis. Some previous attempts, such as interventional selective internal iliac artery embolization or manual ligation through an additional anterior approach, were tested to be ineffective. Inspired by the success of resuscitative endovascular balloon occlusion of the aorta (REBOA) which resemble an endovascular tourniquet for traumatic hemorrhagic shock, some researchers have applied this techinique to control surgical bleeding during pelvic or sacral tumor resection.The authors have performed REBOA for more than 1 500 sacropelvic tumr surgeries since 2003 in Peking University People's Hospital. The patient age, the diameter of femoral artery and aorta, atherosclerosis, as well as tumor location, volume and expansion and blood suppy, have to be thoroughly evaluated prior to REBOA administration. Admittedly, the application of REBOA do reduce intraoperative bleeding, shorten the operation duration, improve the safety of surgery, yet some complications were observed including local hematoma at the puncture site, acute arterial thrombosis, femoral artery pseudoaneurysm or occlusio, et al. The purpose of this study is to review the literature on REBOA administration in pelvic and sacral tumors excision, with the focus on its indications, performing procedure, the safety and efficacy, and complications. Moreover, in order to popularize the clinical application of aortic balloon occlusion in the future, we summarize our experience of abdominal aortic balloon occlusion over 10 years.

OBJECTIVE：To provide reference for improving the mechanism of drug supervision in Guangdong-Hong Kong-Macao Greater Bay Area. METHODS ：Based on the evolutionary game theory ，the stakeholders of Guangdong-Hong Kong-Macao Greater Bay Area in the stage of drug safety supervision were identified ；the evolutionary game model was established so as to obtain the behavioral selection and evolutionary stability strategy of the each party through and put forward the suggestions for improving the mechanism of drug supervision in Guangdong-Hong Kong-Macao Greater Bay Area. RESULTS & CONCLUSIONS：Based on evolutionary game theory ，the three-party evolutionary game model of drug administration ，drug inspection and manufacturing enterprises was established. According to the model established in this study ，it could be concluded that：when the compliance cost of the production enterprise was less than the sum of the violation cost and the bribery cost minus the additional income ，or less than the sum of violation cost and punishment and reputation lossminus the additional income ，the manufacturing enterprises could achieve the equilibrium state of compliance production ；the supervision probability was inversely proportional to the supervision cost ，and strict inspection was inversely proportional to inspection cost ；compliance productivity rate and strict detection rate were in direct proportion to the intensity of supervision and penalties ；the higher the supervision probability was，the higher the strict detection rate was ，and the compliance productivity would gradually increase. It is proposed to link enterprise information files ，lay the foundation of four party cogovernance ；introduce the “cost-benefit”supervision system ，make reasonable use of the third-party inspection institutions ；clarify the boundary of personnel responsibility ，and use the intelligent system for real-time supervision so as to promote the improvement of drug safety supervision in Guangdong-Hong Kong-Macao Greater Ba y Area.

Objective:To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors.Methods:Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People′s Hospital were retrospectively analyzed.There were 8 males and 15 females,with the age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed.Results:Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a percutaneous suture device to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief.Conclusions:Acute femoral arterial thrombosis is the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

Objective:To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors.Methods:Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People′s Hospital were retrospectively analyzed.There were 8 males and 15 females,with the age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed.Results:Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a percutaneous suture device to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief.Conclusions:Acute femoral arterial thrombosis is the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.