Objective:To investigate the stiffness of the gastrocnemius muscle-tendon complex at different ankle joint an-gles and its correlation with foot arch morphology in healthy subjects using shear wave elastography(SWE).Method:Forty healthy subjects were recruited and divided into standard,low-arch,and high-arch groups based on arch height index under load(AHIload).The arch stiffness index was calculated from both loaded and non-loaded arch height.The stiffness of the medial gastrocnemius,lateral gastrocnemius,and achilles tendon were measured by SWE at natural and neutral ankle positions.Result:The stiffness of medial gastrocnemius increased in the low-arch group at the neutral position compared with the high-arch group(P=0.021).The correlation coefficients between the stiffness of medial and lateral gas-trocnemius and the arch stiffness index were 0.355 and 0.484,respectively.The correlation coefficients be-tween passive ankle dorsiflexion range of motion were ﹣0.331 for the medial gastrocnemius and ﹣0.276 for the lateral gastrocnemius.The medial and lateral gastrocnemius stiffness at the natural position did not change with arch height(P>0.05).The stiffness of the achilles tendon at any ankle position showed no significant cor-relation with arch height,arch stiffness index,or passive ankle dorsiflexion range of motion(P>0.05).Conclusion:Individuals with low arches exhibited higher medial gastrocnemius stiffness.Increased arch stiff-ness and decreased passive ankle dorsiflexion were associated with higher medial gastrocnemius stiffness.

Objective:To investigate the stiffness of the gastrocnemius muscle-tendon complex at different ankle joint an-gles and its correlation with foot arch morphology in healthy subjects using shear wave elastography(SWE).Method:Forty healthy subjects were recruited and divided into standard,low-arch,and high-arch groups based on arch height index under load(AHIload).The arch stiffness index was calculated from both loaded and non-loaded arch height.The stiffness of the medial gastrocnemius,lateral gastrocnemius,and achilles tendon were measured by SWE at natural and neutral ankle positions.Result:The stiffness of medial gastrocnemius increased in the low-arch group at the neutral position compared with the high-arch group(P=0.021).The correlation coefficients between the stiffness of medial and lateral gas-trocnemius and the arch stiffness index were 0.355 and 0.484,respectively.The correlation coefficients be-tween passive ankle dorsiflexion range of motion were ﹣0.331 for the medial gastrocnemius and ﹣0.276 for the lateral gastrocnemius.The medial and lateral gastrocnemius stiffness at the natural position did not change with arch height(P>0.05).The stiffness of the achilles tendon at any ankle position showed no significant cor-relation with arch height,arch stiffness index,or passive ankle dorsiflexion range of motion(P>0.05).Conclusion:Individuals with low arches exhibited higher medial gastrocnemius stiffness.Increased arch stiff-ness and decreased passive ankle dorsiflexion were associated with higher medial gastrocnemius stiffness.

Hand, foot and mouth disease (HFMD) is a widespread infectious disease mainly affecting children aged five and under. In China, the current epidemic situation of HFMD remains severe, with a persistently high and increasing incidence rate, causing a substantial disease burden. A monovalent vaccine against Enterovirus A71 (EV-A71), the most common cause of severe and fatal HFMD cases, has been available in China since 2016. Although randomized controlled trials established the vaccine's efficacy among research subjects, this may not reflect the impact under "real world" conditions in the general population. Therefore, based on a systematic literature search, this paper comprehensively reviewed and analyzed relevant studies based on real-world data and collected real-world evidence about the EV-A71 vaccine on the controlling HFMD incidence. It was found that the real-world study of the EV-A71 vaccine on HFMD was few; most were limited to a province or city; there is no study comprehensively considered other important influencing factors in addition to immunization, such as temperature, relative humidity, the age structure of the population, gross domestic product, etc. The progress of using real-world data to study the impact of the EV-A71 vaccine on HFMD reviewed in this study is helpful to have a clear and comprehensive understanding of the status quo and will provide guidance and reference for future studies to assess the short-term and long-term effects of EV-A71 vaccine and other vaccines.

Oxidative Phosphorylation ; Acetylglucosamine ; Uridine Diphosphate N-Acetylglucosamine/metabolism*

Objective:To investigate the reliability and validity of Stanford attendance scale (sps-6) in the study of attendance among professional groups.Methods:In August, 2018, the 1455 employees from 81 workplaces in Beijing, Shanghai, Jiangsu and Guangdong were randomly investigated as the subjects. The reliability and validity of sps-6 were analyzed by using the internal consistency reliability (Cronbach's coefficient) , half split half coefficient, content validity, integration validity, discrimination validity, cluster analysis and structural validity analysis.Results:Cronbach's coefficients of sps-6 scale, working process and work results were 0.692, 0.918 and 0.907, respectively; Guttman of scales and dimensions The split half coefficients were 0.792, 0.803 and 0.794, respectively; Pearson correlation coefficients of the total score of each item and scale were 0.526-0.673 ( P<0.01) ; the qualification rate of set validity and differentiation validity were 100%; the results of cluster analysis supported the theoretical basis for the formation of the scale. The general non-standard fitting index (TLI) =0.982, approximate error mean square root mean square (RMSEA) =0.071, comparative fit index (CFI) =0.990, fit goodness index (GFI) =0.987, modified fit goodness index (AGFI) =0.965, Norm fit index (NFI) =0.990. The results showed that the scale had higher structural validity, and the results of sps-6 in the occupational population were (21.36±4.04) , and the distribution was normal (deviation was 0.053, peak was 0.023) . The scores of sps-6 scale were statistically different in various charactoristics of gender, age, education level, marital status, annual income, position, position level and industry ( P< 0.01) . Conclusion:Stanford attendance scale has high reliability and validity, and can be applied to the study of attendance in professional groups.

Objective:To investigate the reliability and validity of Stanford attendance scale (sps-6) in the study of attendance among professional groups.Methods:In August, 2018, the 1455 employees from 81 workplaces in Beijing, Shanghai, Jiangsu and Guangdong were randomly investigated as the subjects. The reliability and validity of sps-6 were analyzed by using the internal consistency reliability (Cronbach's coefficient) , half split half coefficient, content validity, integration validity, discrimination validity, cluster analysis and structural validity analysis.Results:Cronbach's coefficients of sps-6 scale, working process and work results were 0.692, 0.918 and 0.907, respectively; Guttman of scales and dimensions The split half coefficients were 0.792, 0.803 and 0.794, respectively; Pearson correlation coefficients of the total score of each item and scale were 0.526-0.673 ( P<0.01) ; the qualification rate of set validity and differentiation validity were 100%; the results of cluster analysis supported the theoretical basis for the formation of the scale. The general non-standard fitting index (TLI) =0.982, approximate error mean square root mean square (RMSEA) =0.071, comparative fit index (CFI) =0.990, fit goodness index (GFI) =0.987, modified fit goodness index (AGFI) =0.965, Norm fit index (NFI) =0.990. The results showed that the scale had higher structural validity, and the results of sps-6 in the occupational population were (21.36±4.04) , and the distribution was normal (deviation was 0.053, peak was 0.023) . The scores of sps-6 scale were statistically different in various charactoristics of gender, age, education level, marital status, annual income, position, position level and industry ( P< 0.01) . Conclusion:Stanford attendance scale has high reliability and validity, and can be applied to the study of attendance in professional groups.

Objective To identify the reasons and treatment strategies of epidural fluid collection (EFC) secondary to cranioplasty in patients with traumatic brain injury after decompressive craniectomy.Methods From June 2013 to July 2017,a retrospective analysis was performed on clinical data of 150 patients with traumatic brain injury after decompressive craniectomy in our hospital.A total of 47 patients experienced EFC following cranioplasty and 103 not.Risk factors of EFC after cranioplasty were analyzed by multiple factor Logistic regression.Results For the 47 EFC patients,32 patients had no obvious clinical symptoms and EFC was absorbed gradually through conservative therapy;15 patients had clinical symptoms,such as mental deterioration,headache,or limb weakness.EFC disappeared through vacuation in 4 patients and subcutaneous drainage in 11.The proportions of patients with skull defect＞80 cm2,dural defect and dural calcification in patients with EFC were significantly higher as compared with those without EFC (P＜0.05).Multiple factor Logistic regression analysis showed that skull defect＞80 cm2 and dural mater calcification were independent risk factors for EFC after cranioplasty.Conclusions Patients with large skull defect＞80 cm2 and dural calcification are prone to have EFC after cranioplasty.Careful evaluation of imaging data,good surgical skills and strengthening postoperative management can reduce incidence of EFC after cranioplasty.

Objective To explore the influence of health education and treatment compliance on COPD patients' outcome.Methods 258 subjects (186 males,72 females,average age 75.2±8.5 years) were enrolled from patients diagnosed with COPD between June 2013 to June 2014 in huashan hospital north compus.Study began in July 2014,health condition assessment and grading、telephone follow-up and education were performed once every half a year together with COPD lectures,the number of patients participated in education sessions,and status of smoking cessation,exercise\home oxygen therapy and medication were recorded as indicators for health education compliance.Clinic/hospital stay and cost,condition change were also recorded.The study ended in December 2015 with final assessments of conditions and classification of patient outcome.Multiple logistic regression was used to analyze factors influencing the COPD patient's outcome;Independent sample t test was applied to compare different compliance in patients with outpatient and hospitalization per-time cost difference.Results Higher reimbursement ratio,the better adherence for health education,no complications and the low grade of disease classification at the beginning of the study were protective factors (OR=10.35,2.147,5.791,4.51,P＜0.05);Underweight to normal weight,5 times or more acute attacks during during the study,poor health education compliance were risk factors for disease progression (OR=0.031,0.131,0.010,P＜ 0.05);Never exercise and never participating in health education management are the risk of illness/death((OR=6.793,P=0.005,95％CI:1.766～26.125) vs.(OR=11.872,P=0.002,95％CI:2.525～55.815));for mild COPD patients,these never participating in health education management had a higher per hospitalization than patients with health education management (6 619 yuan,t=2.681,P=0.010).The outpatient cost of more severe COPD patients who are smoking or quitted smoking in less than 5 years was higher than these quitted smoking more than 5 years (985 yuan,t=-2.225,P=0.028).Conclusions Health education management can help medical staff to provide guidance to patients to quit smoking,encouraging the regular use of home oxygen therapy,doing more exercise,taking prescription of preventive drugs,these will in turn improve patient compliance for disease control and prevention.These efforts can effectively slow disease progression and improve patient outcomes,reduce medical costs,reduce the burden of the family and society.

Objective To observe the effect ofTripterygium Wilfordii Hook. F. andTripterygium Hypoglaucum (Lévl.) Hutch on macrophage inflammatory factor, and to provide the oretical basis and experimental basis for the clinical application of these drugs.Methods Two batches ofTripterygium Wilfordii Hook. F. andTripterygium Hypoglaucum (Lévl.) Hutch were collected, and then the samples turned into alcohol extract by extraction and isolation. The IC50values of alcohol extracts were measured by MTT in BMDM cell. BMDM cell induced by the 4 batches of samples with IC50, then IL-6, IL-10, iNOS were detected by Elisa. Results The content of IL-6 (5.08 ± 0.96 pg/ml, 6.24 ± 0.20 pg/mlvs. 7.92 ± 0.84 pg/ml) and iNOS (0.14 ± 0.04 ng/ml, 0.36 ± 0.11 ng/mlvs. 0.86 ± 0.13 ng/ml) in Anhui and Guizhou groups were significantly lower than sulfasalazine (P<0.05), and the content of IL-10 (21.20 ± 4.24 pg/ml, 26.49 ± 4.44 pg/mlvs. 9.06 ± 0.40 pg/ml) in Anhui and Guizhou groups were significantly higher than sulfasalazine (P<0.05). The content of IL-6 (4.22 ± 0.38 pg/ml, 4.55 ± 0.44 pg/mlvs. 7.92 ± 0.84 pg/ml) and iNOS (0.07 ± 0.04 ng/ml, 0.28 ± 0.10 ng/mlvs. 0.86 ± 0.13 ng/ml) in Hunan and Zhejiang groups were significantly lower than sulfasalazine (P<0.05) .Conclusion The anti-inflammatory effect ofTripterygium WilfordiiHook. F. treat rheumatoid arthritis is better than sulfasalazine andTripterygium Hypoglaucum (Lévl.) Hutch.

OBJECTIVE:To systematically review the efficacy of Berberine hydrochloride tablet in the treatment of non-alco-holic fatty liver disease(NAFLD),and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from CJFD,Wanfang Database,VIP,CBM and PubMed,observational studies about Berberine hydrochloride tablet in the treatment of NAFLD were collected. After data extraction and quality evaluation,Meta-analysis was performed by using Rev Man 5.3 statistics software. RESULTS:A total of 6 studies were included,involving 294 patients. Results of Meta-analysis showed Berberine hydro-chloride tablet could significantly reduce the levels of AST[WMD=18.97,95%CI(2.25,35.70),P=0.03],ALT[WMD=31.04, 95%CI(7.17,54.91),P=0.01],TG[WMD=1.07,95%CI(0.39,1.74),P=0.002] and TC[WMD=1.31,95%CI(0.79,1.84),P<0.001] in the serum of patients with NAFLD. There were significant differences. CONCLUSIONS:Berberine hydrochloride tablet can significantly improve the liver function and blood lipid levels of patients with NAFLD,and the clinical efficacy is relatively pre-cise. Due to the limit of methodological quality,it remains to be further verified by large-scale and high quality RCT.