BACKGROUND:The quadriceps strength of patients with osteoporosis and sarcopenia is significantly reduced,which can further reduce the function of the knee joint,affect the function of the lower limbs and even lead to a decrease in whole-body coordination.It is speculated that a reasonable quadriceps training program and personalized guidance are beneficial to the recovery of knee joint function in patients with osteoporosis and sarcopenia.OBJECTIVE:To observe the effect of short-term moderate-intensity resistance rehabilitation training on the mass and function of the quadriceps and knee joint function in patients with osteoporosis and sarcopenia.METHODS:Using the integrated physical examination and rehabilitation model,375 patients with osteoporosis and sarcopenia were screened at the Health Management Center of Shanghai Public Health Clinical Center.They underwent 12 weeks of combined/comprehensive exercise rehabilitation based on resistance exercise,including quadriceps resistance isotonic and isometric contraction training twice a week(3-5 sets each time,10-15 minutes per set)and aerobic exercise/balance exercise two or three times a week(30 minutes each time).Assessments and data collection were performed before rehabilitation training,12 weeks after rehabilitation training,and at follow-up 12 weeks after stopping rehabilitation training,mainly including knee joint range of motion and proprioception,quadriceps muscle strength,and cross-sectional area(magnetic resonance imaging results),pain,knee joint function(Hospital for Special Surgery score)and walking function("up-and-go"time and 6 m pace test results)as well as the patient's psychological status assessment.RESULTS AND CONCLUSION:All 375 patients completed 12 weeks of rehabilitation training and 12 weeks of follow-up without any adverse events.(1)Compared with before training,the patients' gait speed and knee range of motion increased significantly after 12 weeks of rehabilitation training(P＜0.01),the time of"stand-to-walk"decreased(P＜0.01),and the proprioception of the knee joint and the strength of the quadriceps femoris were significantly improved(P＜0.01);and at the follow-up visit 12 weeks after stopping training,the above indicators and functions of the patients were well maintained(P＞0.05).(2)Magnetic resonance imaging results showed that the effective cross-sectional area of the quadriceps femoris did not improve significantly after 12 weeks of rehabilitation training(P＞0.05);but the Hospital for Special Surgery score of knee joint function increased significantly(P＜0.01),and the visual analog pain scale score decreased significantly(P＜0.01),suggesting that this may be related to the improvement of quadriceps femoris quality by resistance rehabilitation training.(3)The results of the Hospital Anxiety and Depression Scale score showed that the anxiety and depression scores of the patients continued to decrease,both at 12 weeks of rehabilitation training and at 12 weeks after stopping training(P＜0.01).It is suggested that resistance rehabilitation training of the quadriceps can help patients with osteoporosis and sarcopenia to restore quadriceps muscle strength,increase range of motion,improve proprioception and joint stability,thereby enhancing knee joint function,reducing pain,improving depression and anxiety,and to a certain extent promoting the coordinated recovery of the musculoskeletal system.

BACKGROUND:The quadriceps strength of patients with osteoporosis and sarcopenia is significantly reduced,which can further reduce the function of the knee joint,affect the function of the lower limbs and even lead to a decrease in whole-body coordination.It is speculated that a reasonable quadriceps training program and personalized guidance are beneficial to the recovery of knee joint function in patients with osteoporosis and sarcopenia.OBJECTIVE:To observe the effect of short-term moderate-intensity resistance rehabilitation training on the mass and function of the quadriceps and knee joint function in patients with osteoporosis and sarcopenia.METHODS:Using the integrated physical examination and rehabilitation model,375 patients with osteoporosis and sarcopenia were screened at the Health Management Center of Shanghai Public Health Clinical Center.They underwent 12 weeks of combined/comprehensive exercise rehabilitation based on resistance exercise,including quadriceps resistance isotonic and isometric contraction training twice a week(3-5 sets each time,10-15 minutes per set)and aerobic exercise/balance exercise two or three times a week(30 minutes each time).Assessments and data collection were performed before rehabilitation training,12 weeks after rehabilitation training,and at follow-up 12 weeks after stopping rehabilitation training,mainly including knee joint range of motion and proprioception,quadriceps muscle strength,and cross-sectional area(magnetic resonance imaging results),pain,knee joint function(Hospital for Special Surgery score)and walking function("up-and-go"time and 6 m pace test results)as well as the patient's psychological status assessment.RESULTS AND CONCLUSION:All 375 patients completed 12 weeks of rehabilitation training and 12 weeks of follow-up without any adverse events.(1)Compared with before training,the patients' gait speed and knee range of motion increased significantly after 12 weeks of rehabilitation training(P＜0.01),the time of"stand-to-walk"decreased(P＜0.01),and the proprioception of the knee joint and the strength of the quadriceps femoris were significantly improved(P＜0.01);and at the follow-up visit 12 weeks after stopping training,the above indicators and functions of the patients were well maintained(P＞0.05).(2)Magnetic resonance imaging results showed that the effective cross-sectional area of the quadriceps femoris did not improve significantly after 12 weeks of rehabilitation training(P＞0.05);but the Hospital for Special Surgery score of knee joint function increased significantly(P＜0.01),and the visual analog pain scale score decreased significantly(P＜0.01),suggesting that this may be related to the improvement of quadriceps femoris quality by resistance rehabilitation training.(3)The results of the Hospital Anxiety and Depression Scale score showed that the anxiety and depression scores of the patients continued to decrease,both at 12 weeks of rehabilitation training and at 12 weeks after stopping training(P＜0.01).It is suggested that resistance rehabilitation training of the quadriceps can help patients with osteoporosis and sarcopenia to restore quadriceps muscle strength,increase range of motion,improve proprioception and joint stability,thereby enhancing knee joint function,reducing pain,improving depression and anxiety,and to a certain extent promoting the coordinated recovery of the musculoskeletal system.

Objective To evaluate the methodological and report quality of the randomized controlled trials(RCT)of Traditional Chinese Medicine(TCM)exercise in patients with Parkinson's disease(PD).Know the current quality status and existing problems,and provide reference for future clinical practice.Methods After Chinese and English databases were searched by computer.We referred to Cochrane 5.1.0 Bias Risk Assessment Tool and the CONSORT 2010 Statement,evaluated the methodology and report quality of the in-cluded RCT.Results 54studies were included,57.4％were Tai chi intervention,the concealment of randomization and allocation schemes,blinding of outcome assessors,and other sources of bias were not adequately reported.96.3％(52studies)had a high risk of blinding subjects and intervenors,only 14.8％(8studies)used and described the concealment of randomization,and 38.9％(21 studies)reported the use of blinding of outcome assessors.The evaluation results of CONSORT statement showed that in total 37subitems,5subitems(13.5％)had a report rate of 0.More than half of the subitems(67.6％)had a report rate of less than 50％,in-cluding concealment of allocation(14.8％),implementation of blinding(38.9％),sample-size estimation(16.7％),intention-to-treat analysis(20.4％),and protocol registration(22.2％),etc.Conclusion The methodological and report quality of RCT were low.In the future,researchers should strictly follow the CONSORT statement to standardize the design,implementation and reporting of RCT,improve the higher methodological quality and pay more attention to outcomes in non-motor function and safety outcomes,then provide o-riginal studies with better quality for PD management and promote them to be transformed and utilized.Finally,promote exercise therapy of traditional Chinese medicine in PD management.

Objective·To analyze the clinicopathologic characteristics,gene mutation profile,and prognostic factors of patients with adrenal diffuse large B-cell lymphoma(DLBCL).Methods·From March 2002 to December 2022,a total of 105 patients with adrenal DLBCL admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed for their clinicopathological data,survival outcomes,and prognostic factors.Patients'gene mutation profiles were evaluated by targeted sequencing of 152 lymphoma-related genes.Results·The median age of the patients was 62(15?82)years and the male-to-female ratio was 2.3∶1.Among them,63 patients(60.0%)were over 60 years old,22 patients(21.0%)had an Eastern Cooperative Oncology Group(ECOG)performance status of two or higher,87 patients(82.9%)were staged Ann Arbor Ⅲ?Ⅳ,92 patients(87.6%)had elevated serum lactate dehydrogenase(LDH)levels(above the upper limit of reference),84 patients(80.0%)had extranodal invasion in at least two organs,67 patients(63.8%)were of non-germinal center B-cell(non-GCB)origin,and 95 patients(90.5%)had an international prognosis index(IPI)scored over 2.With a median follow-up of 28.3(0.7?191.9)months,the estimated 2-year overall survival(OS)rate and progression-free survival(PFS)rate were 68.3%and 53.1%,respectively.The estimated 5-year OS rate and PFS rate were 52.6%and 44.0%,respectively.Among 93 patients who could be evaluated for clinical outcomes,62(66.7%)got a complete response(CR).Univariate analysis and multivariate Cox analysis revealed that age over 60 years was an adverse prognostic factor for PFS,and ECOG performance status of two or higher was an adverse prognostic factor for both OS and PFS.Targeted gene sequencing in 46 adrenal diffuse DLBCL patients showed high mutation frequencies in lysine methyltransferase 2D(KMT2D;n=17,37%),Pim-1 proto-oncogene,serine/threonine kinase(PIM1;n=17,37%),MYD88 innate immune signal transduction adaptor(MYD88;n=15,33%),CD79b molecule(CD79B;n=13,28%),and BTG anti-proliferation factor 2(BTG2;n=10,22%).Conclusion·Age over 60 years is an adverse prognostic factor for PFS,and ECOG performance status of two or higher is an adverse prognostic factor for both OS and PFS in patients with adrenal DLBCL.Patients exhibited high frequencies of KMT2D,PIM1,MYD88,CD79B,and BTG2 mutations,as well as an increased proportion of the MCD-like subtype.

Objective:To develop the Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy and evaluate its reliability and validity.Methods:Based on the theory of unpleasant symptoms, a preliminary version of the Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy was developed through literature analysis, semi-structured interviews, and the Delphi method. After revising certain items in the pre-survey, convenience sampling was used to select patients who underwent bladder instillation chemotherapy in the Department of Urology Surgery of three ClassⅢ Grade A hospitals in Yunnan Province from January to July 2024 as research subjects to test the reliability and validity of the scale.Results:A total of 168 questionnaires were distributed, and 162 valid questionnaires were collected, with a valid response rate of 96.429% (162/168). The Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy covered two areas of symptom severity and symptom distress, comprising five dimensions and 27 items. The Cronbach's α coefficient for the total scale was 0.953, and the split-half reliability coefficient was 0.806. Exploratory factor analysis revealed that the four common factors for symptom severity contributed to 73.196% of the cumulative variance, while the single common factor for symptom distress accounted for 68.285% of the cumulative variance. Confirmatory factor analysis revealed that all indicators met the fit criteria, indicating that the model possessed good goodness-of-fit. The content validity index at the scale level was 0.940, while the content validity index at the item level ranged from 0.833 to 1.000.Conclusions:The Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy developed in this study demonstrates good reliability and validity, and is suitable for evaluating symptoms in patients undergoing bladder infusion chemotherapy.

OBJECTIVE To optimize the molding process of Xiebai Granules(XG)using the Box-Behnken design-response surface method combined with the BP neural network method,and to evaluate the consistency of particle quality between different bat-ches by establishing physical fingerprint.METHODS Dry paste powder was used as the main drug,dry granulation was adopted,and the forming rate,dissolution rate,moisture absorption rate and angle of repose of the granules were used as evaluation indexes,the ex-cipients dextrin,maltodextrin and lactose of the particles,were screened by single factor test combined with simplex-lattice design and entropy weight method,and the optimal excipient ratio was selected.The entropy weight method combined with the Box-Behnken de-sign-response surface method and the BP neural network algorithm were used to optimize the process parameters,and the process veri-fication was carried out.The physical fingerprint was used to comprehensively characterize the bulk density(Da),hygroscopicity(H),moisture(HR),tap density(Dc),angle of repose(α),Hausner ratio(IH),relative uniformity index(Iθ),Carr index(IC),and in-terparticle pore number(Ie),and the consistency of particle quality in different batches was evaluated.RESULTS The optimal ratio of excipients was dextrin 15%,maltodextrin 48%,and lactose 37%.The optimal process parameters were conveying speed 95 r·min-1,pressure wheel speed 4 r·min-1 and hydraulic pressure 7 MPa.The similarity of the physical fingerprints of the five bat-ches of XG was greater than 0.98.CONCLUSION The optimized molding process of XG is stable and feasible,and the quality of different batches of XG is stable,which can provide a reference for the development and industrial scale-up production of XG.

Objective·To analyze the clinicopathologic characteristics,gene mutation profile,and prognostic factors of patients with adrenal diffuse large B-cell lymphoma(DLBCL).Methods·From March 2002 to December 2022,a total of 105 patients with adrenal DLBCL admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed for their clinicopathological data,survival outcomes,and prognostic factors.Patients'gene mutation profiles were evaluated by targeted sequencing of 152 lymphoma-related genes.Results·The median age of the patients was 62(15?82)years and the male-to-female ratio was 2.3∶1.Among them,63 patients(60.0%)were over 60 years old,22 patients(21.0%)had an Eastern Cooperative Oncology Group(ECOG)performance status of two or higher,87 patients(82.9%)were staged Ann Arbor Ⅲ?Ⅳ,92 patients(87.6%)had elevated serum lactate dehydrogenase(LDH)levels(above the upper limit of reference),84 patients(80.0%)had extranodal invasion in at least two organs,67 patients(63.8%)were of non-germinal center B-cell(non-GCB)origin,and 95 patients(90.5%)had an international prognosis index(IPI)scored over 2.With a median follow-up of 28.3(0.7?191.9)months,the estimated 2-year overall survival(OS)rate and progression-free survival(PFS)rate were 68.3%and 53.1%,respectively.The estimated 5-year OS rate and PFS rate were 52.6%and 44.0%,respectively.Among 93 patients who could be evaluated for clinical outcomes,62(66.7%)got a complete response(CR).Univariate analysis and multivariate Cox analysis revealed that age over 60 years was an adverse prognostic factor for PFS,and ECOG performance status of two or higher was an adverse prognostic factor for both OS and PFS.Targeted gene sequencing in 46 adrenal diffuse DLBCL patients showed high mutation frequencies in lysine methyltransferase 2D(KMT2D;n=17,37%),Pim-1 proto-oncogene,serine/threonine kinase(PIM1;n=17,37%),MYD88 innate immune signal transduction adaptor(MYD88;n=15,33%),CD79b molecule(CD79B;n=13,28%),and BTG anti-proliferation factor 2(BTG2;n=10,22%).Conclusion·Age over 60 years is an adverse prognostic factor for PFS,and ECOG performance status of two or higher is an adverse prognostic factor for both OS and PFS in patients with adrenal DLBCL.Patients exhibited high frequencies of KMT2D,PIM1,MYD88,CD79B,and BTG2 mutations,as well as an increased proportion of the MCD-like subtype.

Aim To study the correlation between heart rate variability(HRV)and right ventricular dysfunction(RVD)in patients with heart failure with preserved ejection fraction(HFpEF)combined with atrial fibrillation(AF).Methods 128 patients with HFpEF and AF admitted to our hospital from January 1,2022 to December 31,2024 were se-lected as the research subjects.Based on the results of right heart function assessment,the patients were divided into two groups:the right ventricular dysfunction group(n=53)and the normal right ventricular function group(n=75).Spearman correlation was employed to assess the correlation between HRV parameters and right ventricular function parame-ters.A multi-factor generalized linear mixed-effects model was constructed,with HRV parameters as independent varia-bles and RVD as the dependent variable.Restricted cubic splines were used to investigate the dose-response relationship between HRV parameters and the incidence of RVD.Additionally,the diagnostic value of HRV parameters and combined detection for RVD was analyzed using the ROC curve.Results The levels of HRV parameters(SDNN,SDANN,RMSSD,PNN50,LF and HF)and right ventricular function parameters(TAPSE,FAC and S')in the right ventricular dysfunction group were significantly lower than those in the normal right ventricular function group(P＜0.05).Linear a-nalysis revealed a significant positive correlation between HRV parameters and right ventricular function parameters(P＜0.05).Multifactor generalized linear mixed-effects model analysis demonstrated that SDNN,SDANN,RMSSD,PNN50,LF and HF were negatively correlated with the incidence of RVD(the β coefficients were-0.465,-0.205,-0.559,-0.293,-0.732,and-0.147,respectively,P＜0.05).Restricted cubic spline model analysis indicated a significant nonlinear relationship between HRV parameters and the incidence of RVD(P＜0.05).The AUC value of combined de-tection of HRV parameters was 0.946,with sensitivity and specificity of 93.56％and 94.57％,respectively.Conclu-sion There is a negative correlation between HRV and the incidence of RVD in patients with HFpEF combined with AF.This result offers a critical theoretical foundation for clinical assessment and therapeutic strategies.

Objective To investigate the mechanism of the miR-518a-5p/histone deacetylase 6(HDAC6)axis in DNA oxidative damage in ovarian cancer(OC)SKOV3 cells.Methods Expression levels of miR-518a-5p and HDAC6 mRNA in OC tissues and in various cancer cells(A2780,SKOV3,CAOV3)were detected by qRT-PCR.SKOV3 cells were separated into Control,miR-NC,miR-518a-5p mimics,miR-518a-5p mimics+pcDNA-NC,and miR-518a-5p mimics+pc-HDAC6 groups.Cell proliferation and apoptosis were analyzed by colony-forming assay and Hoechst 33258 staining.Expression of phosphorylated histone H2AX(γ-H2AX)was detected by immunofluorescence assay and reactive oxygen species(ROS)were detected by flow cytometry.HDAC6,Bcl-2-associated X protein(Bax),and B-cell lymphoma-2(Bcl-2)protein expression were analyzed by Western blot.The regulatory relationship between miR-518a-5p and HDAC6 was analyzed by dual luciferase assay.The effect and mechanism of miR-518a-5p on oxidative DNA damage in OC cells were studied in a xenotransplantation tumor model.Results miR-518a-5p expression was decreased and HDAC6 expression was increased in OC tissues and A2780,SKOV3,and CAOV3 cells(P＜0.001).Expression levels of miR-518a-5p were lowest and expression levels of HDAC6 were highest in SKOV3 cells,and SKOV3 cells were therefore selected for subsequent experiments.miR-518a-5p expression,apoptosis rate,number of γ-H2AX-positive cells,relative ROS fluorescence intensity,and expression of Bax were all higher in the miR-518a-5p mimics group compared with the miR-NC group,while HDAC6 mRNA and protein expression,Bcl-2 expression,and colony-formation number were all lower(P＜0.001).HDAC6 mRNA and protein expression,colony-formation number,and expression of Bcl-2 were higher in the miR-518a-5p mimics+pc-HDAC6 group compared with the miR-518a-5p mimics+pcDNA-NC group,and the apoptosis rate,number of γ-H2AX-positive cells,relative ROS fluorescence intensity,and expression of Bax were all lower(P＜0.001).HDAC6 had a targeted regulatory relationship with miR-518a-5p.Overexpression of miR-518a-5p decreased tumor volume,weight,and HDAC6 protein expression in tumor tissues,and increased γ-H2AX expression in vivo(P＜0.001).Upregulation of HDAC6 expression by overexpression of miR-518a-5p increased graft tumor volume,weight,and HDAC6 protein expression and decreased γ-H2AX-positive expression(P＜0.05).Conclusions miR-518a-5p expression is reduced and HDAC6 expression is increased in OC tissues and cells.Overexpression of miR-518a-5p can induce oxidative DNA damage in SKOV3 cells by inhibiting HDAC6 expression,thereby inhibiting cell proliferation and promoting cell apoptosis.

Aim To study the correlation between heart rate variability(HRV)and right ventricular dysfunction(RVD)in patients with heart failure with preserved ejection fraction(HFpEF)combined with atrial fibrillation(AF).Methods 128 patients with HFpEF and AF admitted to our hospital from January 1,2022 to December 31,2024 were se-lected as the research subjects.Based on the results of right heart function assessment,the patients were divided into two groups:the right ventricular dysfunction group(n=53)and the normal right ventricular function group(n=75).Spearman correlation was employed to assess the correlation between HRV parameters and right ventricular function parame-ters.A multi-factor generalized linear mixed-effects model was constructed,with HRV parameters as independent varia-bles and RVD as the dependent variable.Restricted cubic splines were used to investigate the dose-response relationship between HRV parameters and the incidence of RVD.Additionally,the diagnostic value of HRV parameters and combined detection for RVD was analyzed using the ROC curve.Results The levels of HRV parameters(SDNN,SDANN,RMSSD,PNN50,LF and HF)and right ventricular function parameters(TAPSE,FAC and S')in the right ventricular dysfunction group were significantly lower than those in the normal right ventricular function group(P＜0.05).Linear a-nalysis revealed a significant positive correlation between HRV parameters and right ventricular function parameters(P＜0.05).Multifactor generalized linear mixed-effects model analysis demonstrated that SDNN,SDANN,RMSSD,PNN50,LF and HF were negatively correlated with the incidence of RVD(the β coefficients were-0.465,-0.205,-0.559,-0.293,-0.732,and-0.147,respectively,P＜0.05).Restricted cubic spline model analysis indicated a significant nonlinear relationship between HRV parameters and the incidence of RVD(P＜0.05).The AUC value of combined de-tection of HRV parameters was 0.946,with sensitivity and specificity of 93.56％and 94.57％,respectively.Conclu-sion There is a negative correlation between HRV and the incidence of RVD in patients with HFpEF combined with AF.This result offers a critical theoretical foundation for clinical assessment and therapeutic strategies.