Objective To explore the clinical features,treatment and prognosis of glioblastomas(GBM)in adults.Methods A retrospective cohort study was performed on 176 adult GBM patients admitted to our department from January 2015 to December 2021.Chi-square test was used to investigate the clinical differences between isocitrate dehydrogenase(IDH)mutant and wild-type GBM.Kaplan-Meier and Log-Rank tests were employed to plot survival curve and compute the survival analysis.Multivariate Cox regression model was applied to identify the independent prognostic factors.Results IDH wild-type GBM account for 89.2％and had significantly differences from the IDH-mutant GBM in terms of age of onset,Karnofsky(KPS)score at admission,symptoms of neurological deficit,and methylation status of O6-methylguanine-DNA-methyltransferase(MGMT)promoter(P＜0.05).For the IDH wild-type GBM patients receiving conventional therapy,univariate Cox hazard analysis showed gross total resection,methylation of MGMT promoter,initiation of radiation within the 5th to 6th week after surgery,and adjuvant temozolomide(TMZ)chemotherapy ≥6 cycles were favorable prognostic factors for overall survival(OS);GBMs in the left hemisphere,involvement of single lobe,methylation of MGMT promoter,and initiation of radiation within the 5th to 6th week after surgery were favorable prognostic factors for progression free survival(PFS)(all P＜0.05).Moreover,multivariate Cox hazard regression analysis indicated that methylation of MGMT promoter,and initiation of radiation within the 5th to 6th week after surgery,and adjuvant TMZ chemotherapy ≥6 cycles were independent protective factors for OS,and GBMs in the left hemisphere,involvement of single lobe and methylation of MGMT promoter were independent protective factors for PFS in the GBM patients(all P＜0.05).Conclusion The clinical and prognostic features are totally different between IDH mutant and wild-type GBM,and molecular detections are needed for the further pathological classification.Methylation of MGMT promoter is a primary marker of favorite prognosis for IDH wild-type GBM,and slightly delay in radiotherapy(the 5th to 6th week after surgery)can effectively improve the survival prognosis of IDH wild-type GBM.

Objective To explore the effect of long non-coding RNA (lncRNA) NUTM2A-AS1 on the damage of vascular endothelial cells induced by oxidized low density lipoprotein (oxLDL) and its molecular mechanism. Methods Human umbilical vein endothelial cells(HUVECs) were cultured in DMEM medium. The HUVECs treated with 100 μg/mL oxLDL were assigned to oxLDL group, while those cultured under normal conditions were assigned to Con group. After transfection of the lncRNA NUTM2A-AS1 interference expression vector and negative control, microRNA-129-5p mimic and negative control into HUVECs, the cells treated with 100 μg/mL oxLDL were assigned to oxLDL+si-NUTM2A-AS1 group, oxLDL+si-NC group, oxLDL+miR-129-5p group, and oxLDL+miR-NC group, respectively. After co-transfection of the lncRNA NUTM2A-AS1 interference expression vector and miR-129-5p inhibitor or negative control into HUVECs, the cells treated with 100 μg/mL oxLDL were assigned to oxLDL+si-NUTM2A-AS1+anti-miR-129-5p group and oxLDL+si-NUTM2A-AS1+anti-miR-NC group. The levels of malondialdehyde (MDA) in cells, as well as the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were measured using kits. Cell apoptosis was detected by flow cytometry. Protein expression was detected by Western blot. The targeting relationship between NUTM2A-AS1 and miR-129-5p was detected by dual luciferase reporter assay and RNA pull-down experiments. Results Compared with the Con group, the expression level of lncRNA NUTM2A-AS1 was increased, the expression level of miR-129-5p was decreased, the content of MDA was increased, the activities of SOD and GSH-Px were decreased, the apoptosis rate of vascular endothelial cells and the expression levels of cleaved-caspase3 and cleaved-caspase9 were increased in the oxLDL group (P < 0.05). After interference of lncRNA NUTM2A-AS1 expression or overexpression of miR-129-5p, the content of MDA was decreased, the activities of SOD and GSH-Px were increased, cell apoptosis was reduced (P < 0.05). The damage to vascular endothelial cells mediated by knockdown of lncRNA NUTM2A-AS1 under oxLDL conditions can be reversed by downregulation of miR-129-5p. LncRNA NUTM2A-AS1 targeted miR-129-5p for regulation. Conclusion Interference of lncRNA NUTM2A-AS1 expression can inhibit oxLDL-induced vascular endothelial cell damage by targeting miR-129-5p for upregulation.

Objective To investigate the levels of N-terminal probrain natriuretic peptide(NT-proBNP),thrombolomodulin(TM),C-type lectin-like receptor 2(CLEC-2),galectin-3(Gal-3)and their relationships with prognosis in patients with acute coronary syndrome(ACS)after percuta-neous coronary intervention(PCI).Methods A total of 80 patients with ACS were selected as study objects.The patients were followed up for 6 months by outpatient visit or telephone follow-up,and the occurrence of major adverse cardiovascular events(MACE)was recorded in the patients.According to the occurrence of MACE,patients were divided into MACE group(26 cases)and control group(54 cases).The changes of serological indexes were compared between the two groups.Results The expression levels of NT-proBNP,CLEC-2,TM and Gal-3 in serum of patients in the MACE group were significantly higher than those of control group(P＜0.05).Multivariate Logistic regression analysis showed that NT-proBNP,CLEC-2,TM,and Gal-3 were all influential factors for the occur-rence of MACE after PCI in ACS patients(P＜0.05).Conclusion NT-proBNP,CLEC-2,TM and Gal-3 are influencing factors for MACE in patients with ACS after PCI,and have a good predictive role in evaluating the occurrence of MACE.

Objective To investigate the levels of N-terminal probrain natriuretic peptide(NT-proBNP),thrombolomodulin(TM),C-type lectin-like receptor 2(CLEC-2),galectin-3(Gal-3)and their relationships with prognosis in patients with acute coronary syndrome(ACS)after percuta-neous coronary intervention(PCI).Methods A total of 80 patients with ACS were selected as study objects.The patients were followed up for 6 months by outpatient visit or telephone follow-up,and the occurrence of major adverse cardiovascular events(MACE)was recorded in the patients.According to the occurrence of MACE,patients were divided into MACE group(26 cases)and control group(54 cases).The changes of serological indexes were compared between the two groups.Results The expression levels of NT-proBNP,CLEC-2,TM and Gal-3 in serum of patients in the MACE group were significantly higher than those of control group(P＜0.05).Multivariate Logistic regression analysis showed that NT-proBNP,CLEC-2,TM,and Gal-3 were all influential factors for the occur-rence of MACE after PCI in ACS patients(P＜0.05).Conclusion NT-proBNP,CLEC-2,TM and Gal-3 are influencing factors for MACE in patients with ACS after PCI,and have a good predictive role in evaluating the occurrence of MACE.

Objective:To observe any effect of task-oriented training in the activities of daily living (ADL) for stroke patients.Methods:Sixty-two hemiplegic stroke survivors were randomly divided into an experimental group and a control group, each of 31. In addition to routine occupational therapy, the control group exercised on their own, while the experimental group underwent 45-minute task-oriented training sessions based on ADL action analysis every day, 5 days a week for 6 weeks consecutively. Before and after the treatment the upper limb functioning of both groups was quantified using Fugl-Meyer upper limb motor function scoring (FMA-UE) and Brunnstrom staging (BSS). ADL skill was assessed using the modified Barthel index (MBI).Results:After the treatment, the average FMA-UE and MBI scores of both groups were significantly better than before the treatment and better than the control group′s averages. The average BSS scores had also improved significantly, with that of the experimental group significantly better than the control group′s average.Conclusions:Task-oriented training based on ADL motion analysis can significantly improve upper limb motor functioning and ADL ability after a stroke despite hemiplegia. Its efficacy is better than that of conventional occupational therapy alone.

Objective To explore the clinical effect of training assisted by a lower limb rehabilitation robot on the bladder and intestinal function of paraplegic spinal cord injury survivors. Methods Thirty-eight paraplegic patients with spinal cord injury were divided according to their admission order into an experimental group ( n=19) and a control group (n=19). Both groups were given conventional rehabilitation training, while the experimental group was additionally provided with robot-assisted lower limb training in three stages:adaptation, training and con-solidation. It lasted 30 minutes daily, 5 days per week for 12 weeks. Before and after the training, an urodynamics examination system was used to evaluate the maximum urine flow, bladder capacity, residual urine volume, bladder pressure and detrusor pressure. Colon transit time, mean rectal pressure and intestinal function were measured using the colon transit test, a mean rectal pressure test, and the Functional Independence Measure ( FIM) scale respective-ly. Results The average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance, average rectal pressure and intestinal FIM score of the robot training group after training were all significantly better than before the training, as were the average residual urine volume and colon transit time. After the training, the average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance and average rectal pressure of the robot training group were all significantly higher than those of the control group, while the average residual urine volume and colon transit time were significantly smaller. Then, 32％ of the patients in the experimental group achieved no less than 6 points for their average FIM score, significantly higher than in the control group. Conclusion Robot-assisted lower limb training combined with comprehensive rehabilitation training can effectively improve the bladder and intestinal function of paraplegic patients after a spinal cord injury.

Objective: To investigate the health effects of air pollution on elementary school students with the indicator of absenteeism caused by respiratory symptoms and diseases, and to provide a reference for improving their physical health. Methods: Absenteeism, air pollutants, and meteorological data during Sep. 2015 to Jun. 2017 in Pudong, Shanghai were collected. Generalized additive model was used to estimate the effects of air pollution on students’ absenteeism caused by respiratory symptom and diseases, time trends, day of week and meteorological factors were controlled. Results: Totally 47 723 person-days of elementary school students’ absenteeism caused by respiratory symptoms and diseases were recorded during Sep.2015 to Jun. 2016 in Pudong, Shanghai, and the absenteeism rate was 0.07%. The PM2.5 concentration on lag0 and SO2 concentration on lag2 showed the most significant effects, the elementary school students’ absenteeism raised for 1.43% (95%CI=0.25%~2.62%)and 6.79% (95%CI=0.25%~13.32%) respectively with every 10 μg/m3 increment of PM2.5 and SO2. Conclusion Air pollution in Pudong new area have made a influence on the elementary school student’s respiratory symptoms and absenteeism, and the prevention work of air pollution should be strenghthened.

Objective     To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods     A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results     There was no statistical difference in drainage time (4.47±1.03 d vs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 ml vs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60 vs. 26/58, P<0.001). Conclusion     The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.

Objective To analyze the consistency of individual examination diagnosis with terminologies expressed in the conclusion report of physical examinations by the chief inspection physician. Methods Based on the clinical classifications used in the Guidelines on Prevention and Treatment of Blood Lipid Abnormality for Chinese Adults, and related terminology descriptions of Dyslipidemias that were actually used in four-item blood lipid examinations diagnosis, a lexicon database of Hyperlipidemias was constructed with 39 terms used in the four-item blood lipid examination diagnosis and chief physician conclusions. Totally 11953 electronic chief physician inspection reports from 8 health check-up institutions were included. We investigated the terms of lexicon database using word frequency analysis method, calculated the positive rate in the diagnosis of four single examinations of serum lipid and the positive rate in the chief physician's conclusion. Consistency of chief physician's conclusion with single examination diagnosis was analyzed by Kappa test. Results (1) Among the 39 terms of lexicon database, there are 18 nonstandard terms used in single examination diagnosis, accounted for 46％ of all terms; (2) In word frequency analysis, there are only 1％ of terms that corresponded to clinical classifications of Hyperlipidemias accurately;(3) The positive rate of Hyperlipidemias in serum lipid four single examinations diagnosis was 47％, the positive rate of physician diagnosis was 35％. The consistency analysis of chief physician conclusions with single examination diagnosis showed Kappa=0.71(P<0.01). Conclusions Although the final conclusion written by the chief physician was not using standard terms strictly, most of synonymous terminology expressed in the physician conclusion is normative, which enabled the construction of lexicon database and text mining. Whether the single examination diagnosis are consistent with physician conclusions can be an evaluation indicator to assess the quality of chief physician conclusions for physical examinations. Kappa>0.75 may be suggested as a favorable value.

Objective To study the effects of chronic exposure to inorganic arsenic (iAs) in drinking water on bone mineral density (BMD) in mice and its underlying mechanisms.Methods Five-month-old female C57BL/6 mice were randomly divided into sham groups and ovarectomy (OVX) groups (n =19 mice each group),which were further randomly assigned into control group (distilled water) and iAs exposure groups [5 mg/L and 20 mg/L,inorganic arsenite (iAsⅢ):inorganic arsenate (iAsv) =1 ∶ 1].Following 3 months of exposure to iAs,BMD of the mice were determined by the dual energy X-ray detector.RAW 264.7 cell line and bone marrow hematopoietic stem cells (BMHSC) primarily isolated from C57BL/6 mice were used to study the in vitro effects of iAs on osteoclast differentiation and underlying mechanisms.During differentiation induced by receptor activator of nuclear factor-κ B ligand (RANKL,50 μg/L) and macrophage colony-stimulating factor (M-CSF,30 μg/L),RAW 264.7 cell line were treated with 0.00,0.25,0.50,0.75,1.00,1.50 μmol/L iAsⅢ,while BMHSC with 0.0,0.2,0.4,0.6,0.8,1.0 μmol/L iAsⅢ for 6 days.Based on the effect of iAsⅢ on the differentiation of RAW cells,RAW 264.7 cell line were treated by 0.6 μmol/L iAsⅢ combined with 0,5,10 mmol/L of N-acetyl-cysteine (NAC).Tartrate resistant acid phosphatase (TRAP)-positive red-colored cells with 3 or more nuclei were considered mature osteoclast.Results The femoral BMD of the mice [(80.04 ± 4.06) mg/cm2] that had been exposed to 20 mg/L of iAs for 3 months was substantially decreased compared to that of sham control mice [(84.44 ± 4.40) mg/cm2].As expected,the BMD of the OVX group [(76.36 ± 3.36) mg/cm2] was significant decreased compared to that of the sham control group (P ＜ 0.05).However,the BMD among the OVX groups showed no significant difference [5 mg/L:(77.74 ± 4.91) mg/cm2;20 mg/L:(75.56 ± 3.71) mg/cm2,P ＞ 0.05].In vitro studies,the iAsⅢ evidently affected the osteoclast differentiation in a concentration-dependent fashion.Low concentrations of iAs Ⅲ exposure significantly augmented osteoclast differentiation in the two cell models while high concentrations showed inhibitory effect.In RAW 264.7 cells,the number of osteoclasts in different groups was significantly different (F =1 522,P ＜ 0.05),in the 0.50 μmol/L iAs Ⅲ group the number of osteoclasts reached the peak.In the BMHSC,the nmnber of osteoclasts in different groups was also significantly different (F =1 781,P ＜ 0.05),in the 0.6 μmol/L iAsⅢ group the number of osteoclasts reached the peak.NAC pretreatment significantly abolished low-level iAsⅢ(0.6 μmol/L)-induced augmentation of osteoclast differentiation in a concentration-dependent fashion (0 mmol/L:109.33 ± 3.06;5 mmol/L:56.00 ± 2.65;10 mmol/L:22.67 ± 0.58,F =1 940,P ＜ 0.05).Conclusions The inhibitory effect of iAs on bone metabolism is dependent on the availability of ovary function,suggesting that iAs may interfere with estrogen metabolism and/or function to disturb bone metabolism.Oxidative stress induced by iAs exposure stimulates osteoclast differentiation,and the increased osteoclast differentiation may be involved in the reduction of BMD caused by chronic iAs exposure.These preliminary findings suggest that antioxidant intervention may be an effective approach to prevent osteoporosis induced by chronic iAs exposure.