Objective: To explore the relationship of physical activity (PA) and sedentary behavior (SB) with cardiorespiratory fitness (CRF) among middle schoold students in Tibet, so as to provide empirical references for improving the cardiorespiratory fitness and health levels of adolescents in Tibet. Methods: From August to December 2020, 1 225 junior and senior high school students were selected from 2 middle schools in Lhasa, Tibet Autonomous Region, using the stratified cluster random sampling method. Triaxial accelerometers were used to evaluate PA and SB behaviors, and the 20 meter shuttle run was employed to assess CRF among the middle school students. Isochronous substitution modeling was used to analyze the associations of SB, low intensity physical activity (LPA), and moderate vigorous physical activity (MVPA) with CRF, and the saturation threshold effect in the dose response relationship between MVPA and CRF was analyzed through restricted cubic spline and two stage linear regression. Results: After adjusting for covariates such as gender, body mass index and sleep quality score, isotemporal substitution analysis showed that among junior high school students aged 13-15, replacing 30 minutes of SB ( B =1.73) or LPA ( B =2.38) with MVPA were positively associated with CRF (both P <0.05). Among senior high school students aged 16-18, replacing SB ( B =0.99) or LPA ( B =1.38) with MVPA were also positively associated with CRF (both P <0.05). Restricted cubic spline and two piecewise linear regression analyses indicated that only middle school girls aged 13-18 exhibited a saturation threshold effect between MVPA and CRF (logarithmic likelihood ratio test=0.03), with the optimal CRF improvement observed at 60 minutes of MVPA per day ( B=0.13, P ＜ 0.01). Conclusions Reducing SB and LPA while increasing MVPA can improve CRF in Tibetan middle school students. To maximize CRF improvement, middle school girls should engage in at least 60 minutes of MVPA daily.

BACKGROUND: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a severe congenital disorder characterized by vaginal hypoplasia caused by dysplasia of the Müllerian duct. Patients with MRKH syndrome often require nonsurgical or surgical treatment to achieve satisfactory vaginal length and sexual outcomes. The extracellular matrix has been successfully used for vaginal reconstruction. METHODS: In this study, we developed a new biological material derived from porcine vagina (acellular vaginal matrix, AVM) to reconstruct the vagina in Bama miniature pigs. The histological characteristics and efficacy of acellularization of AVM were evaluated, and AVM was subsequently transplanted into Bama miniature pigs to reconstruct the vaginas. RESULTS: Macroscopic analysis showed that the neovaginas functioned well in all Bama miniature pigs with AVM implants. Histological analysis and electrophysiological evidence indicated that morphological and functional recovery was restored in normal vaginal tissues. Scanning electron microscopy showed that the neovaginas had mucosal folds characteristics of normal vagina. No significant differences were observed in the expression of CK14, HSP47, and a-actin between the neovaginas and normal vaginal tissues. However, the expression of estrogen receptor (ER) was significantly lower in the neovaginas than in normal vaginal tissues. In addition, AVM promoted the expression of b-catenin, c-Myc, and cyclin D1. These results suggest that AVM might promotes vaginal regeneration by activating the b-catenin/cMyc/cyclin D1 pathway. CONCLUSION This study reveals that porcine-derived AVM has potential application for vaginal regeneration.

ObjectiveTo confirm the clinical efficacy and safety of Yishen Yangxin Anshen tablets in the treatment of insomnia （heart-blood deficiency and kidney-essence insufficiency syndrome）. MethodA randomized block， double-blind， placebo-controlled， multi-center clinical trial design method was adopted， and a total of 480 patients with insomnia due to deficiency of heart blood and insufficiency of kidney essence （treatment group-control group 3∶1） from seven hospitals （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， The First Clinical Hospital， Jilin Province Academy of Traditional Chinese Medicine（TCM）， The Second Affiliated Hospital of Liaoning University of TCM， The First Affiliated Hospital of Henan University of Chinese Medicine， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine） were enrolled. The treatment group was given Yishen Yangxin Anshen tablets and the control group received placebo tablets （4 tablets/time， 3 times/day， 4 weeks of administration， 4 weeks of follow-up after drug withdrawal）. The sleep dysfunction rating scale （SDRS） score， pittsburgh sleep quality index （PSQI） score， TCM， polysomnography （PSG） indicators from four hospital （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine）， and other efficacy indicators were compared between the two groups before and after treatment. Through general physical examination， laboratory examination， and observation of adverse events， the safety of the drugs was evaluated. ResultThe baseline indexes of the two groups showed no significant difference and thus the two groups were comparable. After treatment， the total score of SDRS in the treatment group was lower than that in the control group （P<0.01）. After drug withdrawal for 4 weeks， the total score of SDRS demonstrated no significant change in the treatment group as compared with that at the end of treatment， indicating that the rebound change of curative effect was not obvious. After treatment， the total score of PSQI in the treatment group decreased as compared with that in the control group （P<0.01）， and the change of total score of PSQI in the treatment group was statistically significant （P<0.05） after drug withdrawal for 4 weeks but small， indicating that the rebound change of curative effect was not obvious. After treatment， the total effective rate about the TCM symptoms in the treatment group was higher than that in the control group （χ²=137.521，P<0.01）. After treatment， the disappearance rates of single indexes in the treatment group， such as difficulty in falling asleep， easily waking up after sleeping， early awakening， short sleep time， dreamfulness， palpitation， forgetfulness， dizziness， mental fatigue， and weakness of waist and knee， increased compared with those in the control group （P<0.01）. After treatment， the treatment group demonstrated fewer awaking times （AT）， longer total sleep time （TST）， lower ATA/TST ratio， and higher sleep efficiency （%） than the control group （P<0.05）. No abnormal value or aggravation related to drugs was observed in either group. The incidence of adverse events in the treatment group and the control group was 5.57% and 8.40% respectively. No serious adverse events or adverse events leading to withdrawal happened in either group. ConclusionYishen Yangxin Anshen tablets is effective and safe for patients with insomnia of deficiency of heart-blood and insufficiency of kidney-essence.

Objective: To investigate the clinical application value of symmetrical three-hole laparoscopic sleeve gastrectomy (LSG). Methods: The retrospective and descriptive study was conducted. The clinical data of 232 patients with obesity who were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2017 to December 2018 were collected. There were 40 males and 192 females, aged (32±8)years, with a range of 17-63 years. All the 232 patients underwent symmetrical three-hole LSG. Observation indicators: (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by telephone interview and WeChat to collect the patient satisfaction with cosmetic effects of wounds at 3 months after surgery up to March 2019. Measurement data with normal distribution were expressed as Mean±SD. Count data were expressed as absolute numbers or percentages. Results: (1) Surgical and postoperative conditions: of the 232 patients, 230 underwent symmetrical three-hole LSG successfully, without conversion to open surgery. Two patients had one puncture hole added due to spleen bleeding to help pull the omentum to stop bleeding, and no spleen hemorrhage recurred after improving the surgical procedure. Of the 232 patients, the operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were (115±7)minutes, (10±5)mL, and (3.0±0.8)days. (2) Complications: of the 232 patients, 10 had postoperative complications of fat liquefaction in the umbilical incision, and were cured after repeated dressing changes. All patients had no serious complications such as gastrointestinal bleeding, abdominal bleeding, or gastric fistula. (3) Follow-up: of the 232 patients, 230 undergoing successful symmetrical three-hole LSG were followed up for 3 months. Of the 230 patients, 3 were dissatisfied with the cosmetic effects of wounds, 12 were satisfied, and 215 were very satisfied. The satisfaction rate was 98.70%(227/230). Conclusion Symmetrical three-hole LSG is safe and feasible, with a good cosmetic effects of wounds.

BACKGROUND:There is no consensus on the choice of elastic stable intramedulary nailing or plate fixation for the treatment of humeral fractures in children.Current research is limited to smal-sample studies,and it is difficult to carry out a large-sample multicenter analysis.OBJECTIVE:To evaluate the efficacy and safety of elastic stable intramedulary nailing and plate fixation for the treatment of humeral fractures in children with meta-analysis.METHODS: The PubMed database,EMbase database,CBM database,CNKI database,VIP database and Wangfang database were searched with computer to colect the controled trials of elastic stable intramedulary nailingversusplate fixation for humerus fractures in children,and related journals were manualy searched.The searching time ranged from the date of database establishment to August 2014.The trails were selected,the data were extracted and the quality was evaluated by two investigators independently.RESULTS AND CONCLUSION: Two randomized controled trials and three retrospective controled trials were included in the meta-analysis.The Meta-analysis results showed that the postoperative functional recovery Constant score of the elastic stable intramedulary nailing group was higher than that of the plate fixation group (P＜0.01).The bone union time,operation time,incision length,intraoperative blood loss and the hospital stay of theelastic stable intramedulary nailing group were less than those of the plate fixation group (P＜0.01).There were no significant differences in incidence rate of complications,nonunion,wound infection and malunion between two groups (P＞0.05).Based on the current evidence,elastic stable intramedulary nailing for the treatment of humeral fractures in children is superior to the plate fixation in the efficacy.There is no significant difference in incidence rate of complications between elastic stable intramedulary nailing and plate fixation.But al the studies were smal-sample,and high-risk original study.Clinical trials with adequate samples,rational design and strict execution shal be carried out to provide more reliable evidence.

BACKGROUND:Numerous studies have shown that local lumbar stenosis can cause immunological abnormalities and local chronic inflammation, which is the main cause of pain. At present, studies on inflammatory factors and lumbar spinal stenosis mainly focused on intervertebral discs, facet joint and ligamenta flava. No reports addressed the relationship between inflammatory factor in vein of lumbar spinal canal and lumbar spinal stenosis. OBJECTIVE:To analyze the correlation of serum interleukin-1αand tumor necrosis factor-αlevels with lumbar spinal stenosis. METHODS:A total of 51 patients with lumbar spinal stenosis or lumbar vertebral burst fracture, who underwent posterior lumbar decompression in the Department of Spine Surgery, Shanghai East Hospital, Tongji University in China from September 2011 to December 2013, were enrol ed in this study. Visual analogue scale score of low back pain and Oswestry disability index were evaluated before treatment. Peripheral vein blood and venous blood in the vertebral canal were col ected from patients with lumbar spinal stenosis or lumbar vertebral burst fracture. The concentrations of serum interleukin-1αand tumor necrosis factor-αwere determined using enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:The concentration of interleukin-1αin degenerative lumbar stenosis group was significantly higher than that in the lumbar burst fracture group and peripheral veins (P<0.05). The more segments of lumbar spinal stenosis, the higher the venous serum interleukin-1αlevels were in the degenerative lumbar stenosis group, but the statistical difference was not significant. Linear correlation analysis results displayed that interleukin-1αlevels were positively associated with low back pain and disability scores in the degenerative lumbar stenosis group (r2=0.359 3, P<0.05;r2=0.526 4, P<0.05). These results indicated that the lumbar spinal venous inflammatory factors may be one of the reasons of low back pain and dysfunction in patients with degenerative lumbar spinal stenosis.

OBJECTIVE:To establish a gas chromatography(GC)method for determination of seven residual solvents in clofarabine.METHODS:The capillary column was AT-1301;the carrier gas was nitrogen gas and the detector was FID.By temperature programming was applied for the column temperature with an initial temperature of 40 ℃,which rose to 80 ℃ with an increase rate of 7 ℃?min-1,then rose to 200 ℃(kept at this temperature for 2 min)with the increase rate of 20 ℃?min-1.The injector temperature was 250 ℃ and the detector temperature was 280 ℃.The sample was injected directly for determination of residual levels of methanol,acetonitrile,dichlormethane,t-butyl alcohol,ethyl acetate,n-heptane and acetic acid in 3 batches of clofarabine.RESULTS:All the organic solvents were effectively separated and they showed good linearity within a concentration range(r=0.999 41～0.999 93)with average recovery rate ranged from 96.5% to 102.4%(RSDs of all were less than 4.0%).7 kinds of organic solvents in 3 batches of samples were all up to the standard specified in Chinese Pharmacopeia.CONCLUSION:The method is sensitive,accurate and reliable,and it is applicable for the determination of the residual solvents in clofarabine.

OBJECTIVE:To provide reference for development of PIVAS.METHODS:Based on the practical condition of our hospital,the necessity of PIVAS and several key problems in the implementation process were analyzed.RESULTS & CONCLUSIONS:It is a natural tendency to establish PIVAS for the development of pharmacy.Several problems such as criteria for PIVAS establishment,charge standard,coverage of drug category and medication chronergy need to be further improved.

OBJECTIVE:To promote standardized management of PIVAS.METHODS:The experience of the management of PIVAS in our hospital was summarized to explore the suitable management model of PIVAS.RESULTS & CONCLUSIONS:The efficiency and quality of PIVAS management is improved and the management of PIVAS is standardized by establishing operational procedure,management criteria,management group and evaluation standard.

OBJECTIVE:To provide reference for improving safety of clinical pharmacy admixture service(PIVAS?DDS).METHODS:The main safety control measures for PIVAS?DDS in our hospital were introduced in respects of system establishment,staff,environment,safety of drug dispensing.RESULTS & CONCLUSIONS:The safety of drug dispensing is greatly inhanced through bettering working system and operational procedure,improving the cleanliness of staff,standardizing regional plan and orientation of human and material resource,which plays an important role in safety of drug use in the clinic and occupational protection,etc.