Purpose To investigate the expression of bone sialoprotein(BSP)in the tissues and cells of endome-trial cancer(EC)and its effects on the proliferation and invasion of EC cells.Methods The expression of BSP was assessed by immunohistochemistry in 235 EC tissues and 88 normal endometrial tissues,and its correlation with clinico-pathological features was analyzed.Western blot was used to compare BSP levels between human endometrial carcinoma cell line(HHUA)and normal human endumetial epithelial cells(HEEC).BSP was knocked down in HHUA cells via transient transfection,and the cells were divided into blank control group and BSP-knockdown group.The effects of BSP knockdown on cell cycle,proliferation,migration,invasion,and apoptosis were evaluated using PI staining,CCK-8,scratch,Transwell,and Annexin V-FITC assays,respectively.Protein levels of TGF-β signaling pathway compo-nents were analyzed by Western blot.Results BSP expression was significantly higher in EC tissues than in normal endometrium(P＜0.001)and correlated with lymph node metastasis and advanced FIGO stage(P＜0.05).BSP pro-tein level was also significantly elevated in HHUA cells(2.455 8±0.008 9)compared to HEECs(1.571 2±0.005 4)(P＜0.01).After knockdown,compared with the control group,the proliferation index(74.4±3.33),migration rate(0.48±0.03),and invasion ability(0.36±0.11)of the cells were increased,and the apoptosis rate(25.97％)of the cells was increased(P＜0.05).Furthermore,the expression levels of TGF-β signaling pathway downstream proteins TGF-β1(0.290 4±0.002 3)、TGF-β2(0.292 9±0.001 6)、Smad2(0.469 3±0.001 1)、Smad3(0.247 0±0.001 7)、pAKT(0.382 1±0.001 9)、ATK(0.119 6±0.001 6)and MEK1(0.258 9±0.000 3)in the BSP-knockdown group of EC cells decreased(P＜0.01).Conclusion BSP is highly expressed in endometrial cancer and promotes cancer cell proliferation,invasion,and metastasis by activating the TGF-β signaling pathway.

Objective To construct a resistance training program for breast cancer related lymphedema,and to examine its feasibility and effects.Methods The first draft of the resistance training program was developed based on the 2 intervenable factors of"muscle contraction"and"chest negative pressure"in lymphatic reflux power source and the best evidence of resistance training.The program was revised and its feasibility was analyzed through 2 rounds of expert demonstration and pilot study.The patients enrolled in 2022.1-2022.5 in a tertiary A hospital in Hefei were assigned to an experiment group(34 cases)and patients enrolled in 2022.9-2023.1 in a tertiary A hospital in Wuhu were assigned to an control group(34 cases)based on convenient sampling method.Both the experiment and control group were given comprehensive decongestive therapy with manual lymphatic drainage,wearing the pressure clothing,and skin care for 12 weeks.The patients in the experiment group were given additional resistance training for 12 weeks.Grip strength and extracellular water/intracellular water(ECW/ICW)of affected upper limb,forced expiratory volume in the first second(FEV1)were evaluated before and 2,4,8,12 weeks after intervention.Results The resistance training program included 4 parts,including resistance breathing training,resistance muscle training,warm-up training and relaxation training.The expert authority coefficient is 0.89;the Kendall coordination coefficient of the first round of expert consultations is 0.42;the coefficient of variation is 0.08～0.27.The Kendall coordination coefficient of the second round of expert consultations is 0.67,and the coefficient of variation is 0～0.19.The pilot study results showed that the completion degree of 5 patients was 62.50％～100％,and there are no adverse events occurred during intervention.A total of 31 patients in the experimental group and 30 patients in the control group completed the 12-week intervention.The results of repeated measurement analysis of variance showed that the increase of grip strength in affected upper limb and FEV1 value in the experiment group were significantly higher than that in the control group(P＜0.05);thie reduction of ECW/ICW value in the experiment group was significantly greater than that in the control group(P＜0.05).Conclusion The resistance training program of breast cancer-related lymphedema is scientific and feasible.It can improve the"muscle contraction"and"chest negative pressure"of lymphatic reflux power source,and relieve lymphedema.

Purpose To investigate the expression of bone sialoprotein(BSP)in the tissues and cells of endome-trial cancer(EC)and its effects on the proliferation and invasion of EC cells.Methods The expression of BSP was assessed by immunohistochemistry in 235 EC tissues and 88 normal endometrial tissues,and its correlation with clinico-pathological features was analyzed.Western blot was used to compare BSP levels between human endometrial carcinoma cell line(HHUA)and normal human endumetial epithelial cells(HEEC).BSP was knocked down in HHUA cells via transient transfection,and the cells were divided into blank control group and BSP-knockdown group.The effects of BSP knockdown on cell cycle,proliferation,migration,invasion,and apoptosis were evaluated using PI staining,CCK-8,scratch,Transwell,and Annexin V-FITC assays,respectively.Protein levels of TGF-β signaling pathway compo-nents were analyzed by Western blot.Results BSP expression was significantly higher in EC tissues than in normal endometrium(P＜0.001)and correlated with lymph node metastasis and advanced FIGO stage(P＜0.05).BSP pro-tein level was also significantly elevated in HHUA cells(2.455 8±0.008 9)compared to HEECs(1.571 2±0.005 4)(P＜0.01).After knockdown,compared with the control group,the proliferation index(74.4±3.33),migration rate(0.48±0.03),and invasion ability(0.36±0.11)of the cells were increased,and the apoptosis rate(25.97％)of the cells was increased(P＜0.05).Furthermore,the expression levels of TGF-β signaling pathway downstream proteins TGF-β1(0.290 4±0.002 3)、TGF-β2(0.292 9±0.001 6)、Smad2(0.469 3±0.001 1)、Smad3(0.247 0±0.001 7)、pAKT(0.382 1±0.001 9)、ATK(0.119 6±0.001 6)and MEK1(0.258 9±0.000 3)in the BSP-knockdown group of EC cells decreased(P＜0.01).Conclusion BSP is highly expressed in endometrial cancer and promotes cancer cell proliferation,invasion,and metastasis by activating the TGF-β signaling pathway.

Objective To construct a resistance training program for breast cancer related lymphedema,and to examine its feasibility and effects.Methods The first draft of the resistance training program was developed based on the 2 intervenable factors of"muscle contraction"and"chest negative pressure"in lymphatic reflux power source and the best evidence of resistance training.The program was revised and its feasibility was analyzed through 2 rounds of expert demonstration and pilot study.The patients enrolled in 2022.1-2022.5 in a tertiary A hospital in Hefei were assigned to an experiment group(34 cases)and patients enrolled in 2022.9-2023.1 in a tertiary A hospital in Wuhu were assigned to an control group(34 cases)based on convenient sampling method.Both the experiment and control group were given comprehensive decongestive therapy with manual lymphatic drainage,wearing the pressure clothing,and skin care for 12 weeks.The patients in the experiment group were given additional resistance training for 12 weeks.Grip strength and extracellular water/intracellular water(ECW/ICW)of affected upper limb,forced expiratory volume in the first second(FEV1)were evaluated before and 2,4,8,12 weeks after intervention.Results The resistance training program included 4 parts,including resistance breathing training,resistance muscle training,warm-up training and relaxation training.The expert authority coefficient is 0.89;the Kendall coordination coefficient of the first round of expert consultations is 0.42;the coefficient of variation is 0.08～0.27.The Kendall coordination coefficient of the second round of expert consultations is 0.67,and the coefficient of variation is 0～0.19.The pilot study results showed that the completion degree of 5 patients was 62.50％～100％,and there are no adverse events occurred during intervention.A total of 31 patients in the experimental group and 30 patients in the control group completed the 12-week intervention.The results of repeated measurement analysis of variance showed that the increase of grip strength in affected upper limb and FEV1 value in the experiment group were significantly higher than that in the control group(P＜0.05);thie reduction of ECW/ICW value in the experiment group was significantly greater than that in the control group(P＜0.05).Conclusion The resistance training program of breast cancer-related lymphedema is scientific and feasible.It can improve the"muscle contraction"and"chest negative pressure"of lymphatic reflux power source,and relieve lymphedema.

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus oxiracetam in treating mild vascular dementia (VD) and seek its underlying mechanism. Methods: Ninety-six patients with mild VD were randomized into an observation group and a control group, with 47 cases in the observation group and 49 cases in the control group. The control group received oral oxiracetam capsules for treatment, and the observation group was given additional Tuina treatment. Before and after treatment, the mini-mental state examination (MMSE) was adopted to assess the patient's cognitive function; the activities of daily living (ADL) scale was used to evaluate their ability to conduct daily activities; changes in the serum inflammatory factors and oxidative stress indicators were also detected. Results: After treatment, the serum content of malondialdehyde (MDA) decreased in both groups (P<0.05) and was lower in the observation group than in the control group (P<0.05); the serum contents of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) increased in both groups (P<0.05) and were higher in the observation group than in the control group (P<0.05); the serum contents of interleukin (IL)-1, tumor necrosis factor (TNF)-α, IL-6, and IL-8 declined in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). After the intervention, the levels of systolic velocity (Vs) and mean velocity (Vm) of the middle cerebral artery elevated, and the pulsatility index (PI) dropped in patients in the two groups, showing significant intra-group differences (P<0.05); the levels of Vs and Vm in the observation group were higher than those in the control group, and the PI was lower in the observation group than in the control group, showing significant between-group differences (P<0.05). The MMSE and ADL scores increased in both groups after the intervention (P<0.05) and were higher in the observation group than in the control group (P<0.05). Conclusion: In the treatment of mild VD, Tuina plus oxiracetam can improve the cerebral blood supply, ADL, and cognitive function; the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.

The coronavirus disease 2019 (COVID-19) pandemic is a major public health event caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread widely all over the world. A high proportion of patients become severely or critically ill, and suffer high mortality due to respiratory failure and multiple organ dysfunction. Therefore, provid-ing timely and effective treatment for critically ill patients is essential to reduce overall mortality. Convalescent plasma therapy and pharmacological treatments, such as aerosol inhalation of interferon-α (IFN-α), corticosteroids, and tocilizumab, have all been applied in clinical practice;however, their effects remain controversial. Recent studies have shown that extracorporeal therapies might have a potential role in treating critically ill COVID-19 patients. In this review, we examine the application of continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), hemoadsorption (HA), extracorporeal membrane oxygenation (ECMO), and extracorporeal carbon dioxide removal (ECCO2R) in critically ill COVID-19 patients to provide support for the further diagnosis and treatment of COVID-19.

Objective To explore the clinical manifestation, diagnosis and prognosis of Leigh syndrome in children. Method Clinical data from 4 cases of Leigh syndrome conifrmed by genetic testing were retrospectively analyzed. The related literature were reviewed. Results In 4 cases, 3 were boys and one was a girl, 3 cases were onset in infant and one case was in school age. The main manifestations were mental retardation, low muscle tone, convulsions, feeding dififculties, drooping eyelids, extraocular muscle paralysis and nystagmus, irritation, activity intolerance etc. The brain magnetic resonance imaging (MRI) revealed symmetry long T1, T2 abnormal signal in brainstem, bilateral globus pallidus, thalamus, cerebellar dentate nuclei, and periaqueductal, 3 cases involved midbrain, one case involved thalamus, and one case involved cerebellar dentate nuclei;2 cases had encephalatrophy. Electromyography was normal in all cases. The levels of lactate in blood and cerebrospinal lfuid were increased. Mitochondrial DNA (mtDNA) detection found the mutation of mtDNA 8993 T>G in one case, and the mutation of mtDNA 9176 T>C in another 3 cases. The case onset in school age died of respiratory failure one month later, and another 3 cases were still in follow up, there were mental retardation, but no signiifcant setback. Conclusion The clinical manifestations of Leigh syndrome in children are diverse. The diagnosis is based on the typical clinical manifestations and MRI, blood and/or cerebrospinal lfuid lactate levels. The genetic testing is the golden standard for diagnosis.

OBJECTIVE To investigate the management criteria for selecting and applying of prosthesis and implants.METHODS Through a standard system and appropriate measures,the strict management to the purchase and entire application of prosthesis and implants was encouraged.RESULTS The systemic management ensured the hospital to use prosthesis and implants safely on patients and prevent from improper or illegal use,thus to safeguard the interests of both the patients and the hospital,avoiding unnecessary harms to patients′ body and spirit,therefore to minimize the conflicts between hospitals and patients.During the implementation of the management,further improvement and investigation were required.CONCLUSIONS Maintaining the mutual inferests between patients and hospital,avoiding unnecessary harms to patients′can minmize the medical conflicts and persistent improvements.

This thesis is the study of the morphology and arterial supply of the papillary musclcs of the left ventricle of 104 human hearts. The maim me-thod used is angiography and corrosion. The commonest number of the anteri-or and posterior papillary muscles is one. In 72 hearts there are musculartrabeculae by which the papillary muscle is attached to the wall of the leftventricle. The projection of the auterior papillary muscle of the left ven-tricle on the heart surface lies most frequently on the middle third regionof a supposed "#"-form region. There are three types of attachment of thepapillary muscle: the free, the attached and the intermidiate, among whichthe largest number is the first type. The arteries supplying the anteriorpapillary muscle are the branches of the anterior descending artery, theleft circumflex artery or these two. Each of the three types amounts to30% or so; the posterior papillary muscle is mostly supplied by the leftventricular posterior branches of the right circumflex artery 9.6 % ). The blood vessels in the papillary muscle belong to class B, each of the papillarymuscles containing 1--3 major vessels measured 0. 1--1 mm in diameter.The three vascular distribution types in the papillary muscle are of axis,segment and mixtnre, and the axial type is most commonly seen of all. Thevascular distribution type j? of certain relation to the attachment type ofthe papillary muscle. The axial distribution is frequently found in the freetype of the papillary muscle. The arteries distributes on either side of thepapillary muscle.

Using the angiography and the corrosion methods we studied the arterial distribution of the papillary muscles of the left ventricle in llo dog hearts, according to the peculiarities of vasculature, disscused the influence of obstruction of coronary artery upon the papillary muscle.The anterior and posterior papillary muscles in dog all are tethered type. The average length and width of anterior papillary muscle are 1.96 cm. and 1.10cm, respectively, while those in the posterior papillary muscle are 2.04 cm. and 1.20 cm. respectively.The origins of arterial blood supply of anterior papillary muscle may be classiffied into 4 types, type Ⅰ, in which the arterial branehes are from the anterior descending artery, is in leading position(71%); type Ⅱ, in which branches are both from the anterior descending and left circumflex arteries, is in the next place(18%). Origins of arterial branches of posterior papillary muscle are classed under 2 types: type Ⅰ, in which all arterial branches are from the left circumflex artery, is the most, 91%, among them 65% from the posterior branch of the left ventricle.The peculiarities of arterial distribution in papillary muscles are as follows: 1. All artery branch entering the papillary muscle are of Class B. 2. All are segmental distribution in papillary muscles. Each muscle recieyes 2-9 branches, mostly 5 or 6 branches. 3. Each half of one papillary muscle recieves several branches symmetrically. 4. The arrangement of hrauches may be classiffied into several types; mixed type is the most, then comes the transverse type. 5. The branches anastomose each other to form the subendocardial plexus, which is most evident in the middle and upper third of the papillary muscle.