Objective:To compare the effect of a 3D-printed ankle and foot orthosis (AFO) with that of a traditional AFO on the recovery of walking function after a stroke.Methods:Thirty-four hemiplegic stroke survivors were randomly divided into an observation group and a control group, each of 17. Both groups were taught good limb placement and given joint mobility, standing and walking training for 4 weeks wearing either a 3D-printed or a conventional AFO. Walking speed, walking endurance, and dynamic balance were evaluated before and after the experiment using the 10-metre walk test (10MWT), the 6-minute walk test (6MWT), and the timed up and go test (TUGT). Integrated electromyography (iEMG) was also performed on each subject′s bilateral rectus femoris, anterior tibialis, and gastrocnemius muscles during walking, and their healthy and affected side iEMG results were compared to assess the activation of the affected lower limb muscles.Results:After treatment, the 10MWT, 6MWT, and TUGT results of both groups had improved significantly, but the observation group′s average results were then significantly better than those in the control group. The iEMG disparities between the healthy and affected sides had also decreased significantly, but on average the disparities in the observation group were significantly smaller than in the control group.Conclusion:Both types of AFO can effectively improve the walking speed, walking endurance, and dynamic balance of hemiplegic stroke survivors and promote muscle activation in the affected lower limb. A 3D-printed AFO is relatively more effective.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Drug metabolism and pharmacokinetics (DMPK) is an important branch of pharmaceutical sciences. The nature of ADME (absorption, distribution, metabolism, excretion) and PK (pharmacokinetics) inquiries during drug discovery and development has evolved in recent years from being largely descriptive to seeking a more quantitative and mechanistic understanding of the fate of drug candidates in biological systems. Tremendous progress has been made in the past decade, not only in the characterization of physiochemical properties of drugs that influence their ADME, target organ exposure, and toxicity, but also in the identification of design principles that can minimize drug-drug interaction (DDI) potentials and reduce the attritions. The importance of membrane transporters in drug disposition, efficacy, and safety, as well as the interplay with metabolic processes, has been increasingly recognized. Dramatic increases in investments on new modalities beyond traditional small and large molecule drugs, such as peptides, oligonucleotides, and antibody-drug conjugates, necessitated further innovations in bioanalytical and experimental tools for the characterization of their ADME properties. In this review, we highlight some of the most notable advances in the last decade, and provide future perspectives on potential major breakthroughs and innovations in the translation of DMPK science in various stages of drug discovery and development.

Purpose: This study aimed to examine the reliability and validity of the Chinese-translated Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) for nursing home residents. Methods: A convenience sample of 204 nursing home residents were used for measuring the instrument performances. Demographics form and BREQ-2 developed by Markland were applied. Results: The translated BREQ-2 model was a good fit for the results of confirmatory factor analysis, χ2 was 276.75, comparative fit index was .94, standardized root mean square residual was .05, and root mean square error of approximation was .07. Results in the BREQ-2 indicated good consistency, Cronbach's α coefficient of BREQ-2 was .78, and each of the five subscales were ranged from .78 to .83. The test–retest was valued .84, and the five subscales ranged from .75 to .89, which supporting the stability of instrument. Conclusion This study provided psychometric evidence for the application of BREQ-2 among nursing home residents in China.

Purpose: This study aimed to examine the reliability and validity of the Chinese-translated Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) for nursing home residents. Methods: A convenience sample of 204 nursing home residents were used for measuring the instrument performances. Demographics form and BREQ-2 developed by Markland were applied. Results: The translated BREQ-2 model was a good fit for the results of confirmatory factor analysis, χ2 was 276.75, comparative fit index was .94, standardized root mean square residual was .05, and root mean square error of approximation was .07. Results in the BREQ-2 indicated good consistency, Cronbach's α coefficient of BREQ-2 was .78, and each of the five subscales were ranged from .78 to .83. The test–retest was valued .84, and the five subscales ranged from .75 to .89, which supporting the stability of instrument. Conclusion This study provided psychometric evidence for the application of BREQ-2 among nursing home residents in China.

Objective:To validate the physical activity model for the elderly in nursing homes based on the self-determination theory (SDT) under the Chinese scenario and provide a theoretical basis for future interventions by clarifying the relationship between autonomy support, basic psychological needs, motivation and physical activity in the elderly in nursing homes.Methods:Totally 204 senior citizens from 6 nursing homes in Shenyang City were selected by convenient sampling from March 7 to 13, 2018. The self-made general information questionnaire, Perceived Autonomy Support (PAS) , Psychological Need Satisfaction in Exercise Scale (PNSE) , Revised Behavioral Regulation in Exercise Questionnaire (BREQ-2) and pedometers were used to collected their basic information, autonomy support, psychological satisfaction in exercise, motivation and physical activity. The statistical method of structural equation model was employed to validate the model.Results:The coefficient of 14 paths in the model was significant [χ 2=44.81, degree of freedom ( df) =31, χ 2/ df=1.45, comparative fit index ( CFI) =0.99, root-mean-square error of approximation ( RMSEA) =0.05, standardized root-mean-square residual ( SRMR) =0.03], showing the model simulation was sound. Autonomy support could predict the level of physical activity through the complete mediation of basic psychological needs and motivation. The positive effect of autonomy support on basic psychological needs was 0.96, and the predictive power of the three basic psychological needs for motivation was attribution (0.93) , autonomy (0.88) , and competence (0.81) from high to low. The positive effect of basic psychological needs on autonomous motivation was 0.82, and their negative effect on controlled motivation and amotivation was -0.94 and -0.65, respectively. The positive effect of autonomous motivation on physical activity was 0.64. The negative effect of controlled motivation on physical activity was -0.22, and the negative effect of amotivation on physical activity was -0.19. Conclusions:As a model for understanding the generation and development process of physical activity motivation, SDT is universal and applicable to the elderly population in the context of Chinese culture.

AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.

Objective: To explore correlation between QRS complex duration and left ventricular ejection fraction (LVEF) in patients with complete left bundle branch block (CLBBB).Methods: A total of 213 patients, who were diagnosed as left bundle branch block by ECG in our hospital from Feb 2012 to Jun 2013, were selected.According to QRS complex duration, patients were divided into CLBBB group (n=182) and incomplete left bundle branch block (ICLBBB) group (n=31).Linear correlation analysis was used to analyze the correlation between QRS complex duration and LVEF, and receiver operating characteristic curve (ROC) was used to analyze optimal cutoff point of QRS complex duration for predicting LVEF<50%.Results: Compared with ICLBBB group, there was significant rise in QRS complex duration [(104.61±8.85) ms vs.(149.36±17.25) ms] and significant reduction in LVEF [(54.26±4.96)% vs.(45.22±12.57)%] in CLBBB group, P<0.01 both.Linear correlation analysis indicated that QRS complex duration was significant inversely correlated with LVEF (r=-0.55, P=0.001) in CLBBB patients.ROC analysis indicated that optimal cutoff point of QRS complex duration for predicting LVEF<50% was 151ms, the area under the curve was 0.79 (P=0.001),its sensitivity was 68.1% and specificity was 83.5%.Conclusion: QRS complex duration is significant inversely correlated with LVEF in CLBBB patients, which can be used as a simple index predicting reduced LVEF.

Background and purpose:The young breast cancer patients were treated with goserelin without individualized regimen, and lack of available clinical marker. The aim of this study was to investigate the role of anti-Müllerian hormone (AMH) in evaluation of individualized treatment of ovarian function suppression in the young breast cancer patients.Methods:Forty-one young patients with estrogen receptor (ER) and progesterone receptor (PR) positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment, one group was treated with goserelin + chemotherapy (n=20), and the other group received chemotherapy alone (n=21). Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin + chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase (day 3-5) of the cycle preceding the operation and 3, 6 courses after the goserelin + chemotherapy treatment or chemotherapy treatment, serum levels of AMH, FSH and E2 were measured in 2 groups. Accordingly, serum levels of AMH, FSH and E2 were evaluated as well in normal control group.Results:There were no signiifcant differences in preoperative general conditions and preoperative serum FSH and E2 levels among the 3 groups (P>0.05). Compared with normal control group, the preoperative serum AMH levels of young breast cancer patients were decreased signiifcantly (P=0.04). The menopause time and menstrual recovery time in 2 chemotherapy groups were signiifcantly shorter than that in normal control group (P=0.00). Compared with normal control group and preoperative measurement, the differences in serum FSH and E2 levels were not statistically significant in goserelin + chemotherapy group or chemotherapy alone group (P<0.05). The serum AMH levels measured at different time points of the goserelin + chemotherapy group and chemotherapy alone group were decreased signiifcantly (P<0.05). Compared with the chemotherapy group, the serum AMH levels of the goserelin + chemotherapy group after 6 courses were signiifcantly decreased, and then signiifcantly increased 6 months after menstrual recovery (P<0.05).Conclusion:This study demonstrated that the serum AMH levels were obviously decreased after the ovarian function suppression treatment and increased after the menstrual recovery compared with evaluation of other ovarian reserve index. The serum AMH level could suggest ovarian reserve damage even after ovarian function has recovered to the noticeable level. Thus, AMH could be used clinically to evaluate the ovarian reserve of breast cancer patients as a potential marker for the individualized ovarian function suppression treatment in young breast cancer patients.

Objective To compare the effects between the impact of IL-7Rα,bacterial flagellin alone to the acute graft-versus-host disease and the combination of both,and to explore its possible mechanism.Methods The BALB/C (H-2d) female mice as recipients were divided into alone irradiation transplantation group (group A),IL-7Rα intervention group (group B),bacterial flagellin intervention group (group C),IL-7Rα combined with bacterial flagellin intervention group (group D),and 6 mice in each group.All mice were accepted 9 Gy 60Co total body irradiation,and 1×107 bone marrow cells and 2× 107 spleen cells of donors C57BL/6 (H-2b) mice were infused via the tail vein to recipient mice.The symptoms,signs,survival time and hematopoietic function recovery of the recipient mice were observed.Results Mice survival of group A was (22.5±2.30) d,30 d survival rate was 50.0 ％ (3/6),and aGVHD performances inculding the fatigue,anorexia,hair removal,arched,and so on appeared obviously.Survival of group B was (25.83±3.49) d,30 d survival rate was 33.3 ％ (2/6),aGVHD performances compared with group A was lighter.Survival of group C was (26.33±3.52) d,30 d survival rate was 33.3 ％ (2/6),also appeared aGVHD performance,which degree was same to the group B.survival of group D was (30.17±2.86) d,30 d survival rate was 66.7 ％ (4/6),aGVHD performances compared to the other three groups was lightest.The white blood cell count of four groups were reduced to minimum at +7 d,then the three intervention groups gradually recovered.The WBC recovery at 14,21,28,30 day after the transplant of group A compared with slowly was the intervention groups (P ＞ 0.05),WBC recovery of B was roughly equal to group C (P ＞ 0.05),while the WBC recovery of group D was faster than group B or C (P ＜ 0.05).At 2nd week after transplantation,CD3+ T cells was significantly decreased in 4 groups,and at 3rd week began gradually rised.Compared with group A,the proportion of CD3+ cells of other three groups were increased significantly,there was no statistical signifiance of CD3+ cell proportion between group B and group C at 2nd,3rd,4th week after transplantation (P ＞ 0.05),while the CD3+ T cell recovery in group D was faster than group B or C (P ＜ 0.05).Conclusions The stable aGVHD mouse model was established.Exogenous IL-7Rα and bacterial flagellin may reduce the incidence of aGVHD.There was no significant difference for aGVHD when they was used alone,but when combination of them,aGVHD is slighter and the hematopoietic recorery is faster.