BACKGROUND:Functional training has been popular in recent years,but it is mainly applied in sports training field.There are still insufficient studies and applications in medical and health fields. OBJECTIVE:To provide a theoretical basis for relevant research in sports,medical and health fields,through a more comprehensive and in-depth exploration and analysis of the research hot spots,ideological trends,frontiers and development trends of international functional training in the field of medical and health care. METHODS:The 2 206 high-quality articles addressing health-related functional training during 2012-2022 were exported from the Web of Science Core Set Database as the object of analysis.Combined with research methods such as literature analysis,Citespace V analysis software was used for visual analysis of keywords,subject categories and highly cited literatures. RESULTS AND CONCLUSION:The number of articles published on functional training in the field of health is on the rise.There are more articles from the United States,with a larger impact.China also has a high volume of publications,but the impact and depth of research is lacking.Improving physical and mental health and cognitive ability of middle-aged and older people is the main focus,followed by preventing sports injuries and promoting recovery in athletes.In the future,more research will be conducted on teenagers,the disabled and other groups,and there will be a continued increase in injury prevention and recovery promotion for athletes.Chinese scholars have less research on the effects of functional training on the physical health of the general public,and more attention should be paid to improving the physical and mental health of the general public.

Objective:To investigate the effectiveness of medical simulation for improving the quality of standardized residency training during clinical anesthesia rotation.Methods:Thirty-six newly admitted anesthesia residents in 2019 were randomly divided into control group and simulation training group, with 18 people in each group. During a week of admission training, the control group learned theoretical knowledge such as sterile techniques, and observed practical videos about central venous puncture, tracheal intubation, spinal puncture, nerve block, and other skills; and the simulation training group practiced the above skills with intelligent medical simulators in the simulation operating room. After a month of rotation, the trainees were assessed on sterile techniques, invasive procedures, and humanistic care, and questionnaires were used to survey the self-rated and teacher-rated scores of their performance. SPSS 22.0 was used to perform the t test and χ2 test. Results:The simulation training group was superior to the control group in terms of the operating processes of tracheal intubation, deep vein puncture, and spinal puncture [(74.16±2.35) vs. (76.05±1.89); (20.22±1.43) vs. (18.61±1.78); (23.17±0.78) vs. (21.11±1.13)], the overall scores of deep vein puncture and spinal puncture [(22.78±1.68) vs. (20.83±1.42); (23.28±0.75) vs. (21.83±1.09)], and the hand-eye coordination and operating time of nerve block [(15.78±1.38) vs. (14.33±1.51); (15.28±1.30) vs. (13.39±1.40)].Conclusions:Medical simulation training can significantly improve the post competencies of anesthesia residents to enter clinical rotation, which is worth further promotion.

ObjectiveTo explore the mechanism of plumbagin as a novel ferroptosis inducer in bladder cancer inhibition. MethodBladder cancer T24 cells were used in this study. The effect of different concentrations of plumbagin （0.1， 1， 2， 3， 6， 12， 24， 48 μmol·L^-1） on the viability of T24 cells was detected by cell counting kit-8 （CCK-8）. The effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L^-1） on the apoptosis of T24 cells was detected by annexin V-fluorescein isothiocyanate （Annexin V FITC）/PI apoptosis kit. Different inhibitors （ferroptosis inhibitor Fer-1， apoptosis inhibitor VAD， and necroptosis inhibitor Nec-1） were used in combination with plumbagin （6 μmol·L^-1）. Reactive oxygen species （ROS） fluorescent probe （DCFH-DA）， malonaldehyde （MDA）， and glutathione （GSH） kits were used to detect the effects of different concentrations of plumbagin （1.5， 3， 6 μmol·L^-1） on the level of ROS and the content of MDA and GSH in T24 cells， respectively. The effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L^-1） on peroxide levels in T24 cells was detected by C11-BODIPY fluorescent probe. Western blot was used to detect the effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L^-1） on the protein expression of solute carrier family 7 member 11 （SLC7A11）， glutathione peroxidase 4 （GPX4）， nuclear factor E₂-related factor-2 （Nrf-2）， and Kelch-like ECH-associated protein 1 （Keap1）. ResultCompared with the blank group， plumbagin could inhibit the activity of T24 cells （P<0.05） with IC₅₀ of 3.52 μmol·L^-1. At the concentrations of 1.5， 3， 6 μmol·L^-1， plumbagin significantly promoted the apoptosis of T24 cells （P<0.05） as compared with the blank group. Compared with the plumbagin group at 6 μmol·L^-1， the ferroptosis inhibitor and apoptosis inhibitor groups could reverse the inhibitory effect of 6 μmol·L^-1 plumbagin on the proliferation of T24 cells （P<0.05）. Compared with the blank group， the plumbagin groups at 1.5， 3， 6 μmol·L^-1 showed increased content of ROS， MDA， and lipid peroxides in T24 cells， decreased GSH level， and reduced SLC7A11， GPX4， and Nrf-2/Keap1 （P<0.05）. Conclusionplumbagin can induce ferroptosis， and its mechanism is related to the Nrf-2/Keap1 signaling pathway.

【Objective】 To provide reference for formulating preoperative blood preparation plan for malignant osteosarcoma scientifically and rationally under the persistent COVID-19 epidemic by studying the high-risk influencing factors related to intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Methods】 The general data, preoperative blood routine and coagulation parameter, clinicopathological record and surgical data of 120 patients with primary malignant osteosarcoma in Beijing Jishuitan Hospital from January 2020 to January 2021 were retrospectively analyzed by univariate analysis, multivariate regression analysis and Pearson correlation analysis to determine the high risk factors for intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Results】 The incidence of intraoperative and postoperative blood transfusion of malignant osteosarcoma patients were 48.33% (58/120) and 62.50% (75/120), with the average blood transfusion units at (1.36±1.14) U and (2.93±2.26) U, respectively. The univariate analysis showed that such factors as sex, preoperative Hct (%), preoperative Plt (×10⁹/L), location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). Multivariate logistic regression analysis showed that sex, location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). 【Conclusion】 For primary malignant osteosarcoma with a high rate of intraoperative blood transfusion, early intervention should be carried out according to the high-risk factors of intraoperative blood transfusion, and preoperative blood preparation plan should be accurately formulated to effectively reduce the rate and units of blood transfusion in patients under the premise of surgery safety.

Background Global warming may increase the frequency of compound hot extreme (CHE).However, there is still a lack of studies assessing the associations between CHE and preterm birth (PTB), and the underlying biological mechanisms remain unclear. Objective To estimate the association of exposure to CHE during pregnancy with PTB, and to explore the roles of inflammatory, endothelial dysfunction, and oxidative stress in the association between CHE and PTB. Methods All participants were selected from the Prenatal Environments and Offspring Health (PEOH), a prospective birth cohort conducted in Guangzhou. In this study, a total of 2449 participants who gave birth from May to October in 2014 to 2017 were enrolled, and among them blood samples were collected from 311 preterm (n=43) and full-term (n=268) pregnant women at the time of delivery. A hot day/night was identified as a day when the daily maximum temperature/minimum temperature was higher than its 90th percentile in the study period, and a CHE was defined as having both a hot night and a following hot day. The meteorological data were obtained from the China Meteorological Data Sharing Service System. Anusplin was used to assess the daily maximum temperature, daily minimum temperature, and relative humidity of the participant residence. Enzyme-linked immunosorbent assay (ELISA) was used to measure C reactive protein (CRP), endothelin-1 (ET-1), and malondialdehyde (MDA) levels in maternal serum, and their results were transformed by natural logarithm. A distributed lag nonlinear model was used to investigate the associations of exposures to hot day, hot night, and CHE during pregnancy with PTB at different lag days, and a logistic regression model was used to investigate the associations of CRP, ET-1, and MDA with PTB. Results The incidence rate of PTB was 6.2% in all selected participants. Compared with the non-hot day, the RRs (95%CIs) of CHE in lag 3, 7, and 14 days on PTB were 1.43 (1.12-1.84), 1.24 (1.08-1.43), and 1.17 (1.05-1.30), respectively, and the cumulative effects (% difference) (95%CI) of CHE in lag 14 days on maternal serum CRP, ET-1, and MDA were 0.33% (−0.45%-1.12%), 0.59% (0.11%-1.07%), and 0.57% (0.09%-1.05%), respectively. Compared with the Q1 (lowest quartile) for CRP, ET-1 and MDA, the RRs (95%CIs) of Q4 (highest quartile) for PTB were 1.27 (0.50-3.22), 1.51 (0.61-3.72), and 2.07(0.81-5.27), respectively. Conclusion Maternal exposure to CHE during pregnancy might be associated with an increased risk of PTB. Prenatal exposure to CHE is positively associated with maternal serum CRP, ET-1, and MDA, and the three biochemical indicators are also positively associated with PTB. However, the above conclusions still need further confirmation.

【Objective】 To explore the influencing factors of blood transfusion in burn patients during hospitalization, so as to provide references for the development of individualized blood transfusion strategies. 【Methods】 116 cases of flame burns and 46 cases of high-voltage burns from Jan 2015 to Jan 2019 were retrospectively analyzed. The gender, age, height, weight, body mass index (BMI), burn surface area, burn depth, burn site, intraoperative blood loss, postoperative flow, number of operations, hospital stays, blood transfusion amount, whether complicated with inhalation injury, stress ulcer, amalgamative infection, hypertension, diabetes, cardio-related diseases, abnormal liver and kidney function and hypoalbuminemia in those two groups were statistically analyzed. 【Results】 During hospitalization, the mean blood volume of flame burn cases was (29.26±26.18)U, significantly higher than high-voltage burn cases as (13.26±10.32)U. The mean hemoglobin concentration (g/L) before blood transfusion of flame burn cases was (91.49±15.11)g/L, significantly higher than high-voltage burn cases as (81.70±14.49)g/L. There were statistically significant differences in gender, BMI, burn surface area, burn depth and burn site between flame burn cases and high-voltage burn cases (P<0.05). The average volume of blood transfusion during hospitalization was significantly affected by such factors as large burn area, trunk involvement, total intraoperative blood loss ≥2 000 mL, number of operations ≥6 times, hospital stay≥100 days, hypertension, cardio-related diseases, abnormal liver and kidney function, hypoproteinemia and so on (P<0.05), among which the total amount of intraoperative blood loss had the most significant effect on the flame burn patients (P<0.05), and the burn site had the most significant effect on the high voltage burn patients (P<0.05). 【Conclusion】 Large burn area, deep burn depth, important organs and/or large blood vessels involvement, number of operations ≥6, and the total intraoperative blood loss ≥2 000 mL contribute to the increase of average volume of blood transfusion. The hypertension, cardio-related diseases, abnormal liver and kidney function, and hypoproteinemia were high risk factors for increased blood transfusion volume during hospitalization, which deserves great attention.

Objective:To evaluate the relationship between degrees of biliary obstruction and levels of lipid peroxidation in patients.Methods:A total of 140 patients of both sexes, with biliary obstruction, without biliary puncture and drainage, aged 40-64 yr, with body mass index of 18.5-23.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were selected.The patients with different degrees of biliary obstruction were divided into 4 groups ( n=35 each) according to Child-Pugh grade total bilirubin (TBIL) concentrations: group A (TBIL<17 μmol/L), group B (17 μmol/L≤TBIL<34 μmol/L), group C (34 μmol/L≤TBIL<51 μmol/L) and group D (TBIL≥51 μmol/L). The serum TBIL, direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acid (TBA) and malondialdehyde (MDA) concentrations were measured.The correlation between serum MDA concentration and degree of biliary obstruction was tested by Spearman correlation analysis. Results:Compared with group A and group B, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group C and group D ( P<0.05), and there was no significant difference in the parameters mentioned above between group A and group B ( P>0.05). Compared with group C, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group D ( P<0.05). Serum MDA concentration was positively correlated with degree of biliary obstruction ( r=0.54, P<0.05). Conclusion:The degree of biliary obstruction can reflect the level of lipid peroxidation in patients.

Objective: To predict the prognosis of cervical cancer, we constructed a novel model with 5 specific cell types and identified a potential biomarker. Methods: We employed CIBERSORT and xCell method to evaluate the abundances of 23 cells types in tumor microenvironment. Five specific cell types were filtrated to determine different immunotypes by applying least absolute shrinkage and selection operator (LASSO) Cox regression method. The expression of immune checkpoints (ICPs) and effectors were validated by immunohistochemistry. Correlation analysis was performed to examine the relevance between PIK3CA mutational status and ICPs. Results: Unsupervised clustering of patients on the basis of tumor infiltrating lymphocytes and fibroblasts identified patients with shorter overall survival (OS) (hazard ratio [HR]=3.0729; 95% confidence interval [CI]=1.5103–6.2522; p=0.0118). An immunoscore (IS) signature consisting of 5 immune cell types infiltrating in tumor core (CD8T, activated NK cells, neutrophils, activated mast cells, macrophages) was constructed using LASSO Cox regression analysis. Receiver operating characteristic curves confirmed that the area under the curve of IS was significantly higher to that of International Federation of Gynecology and Obstetrics staging alone (0.637 vs. 0.55). Survival analysis revealed patients in high IS group exhibited a poorer OS (HR=3.0113; 95% CI=1.8746–4.8373; p<0.0001). The multivariate analysis indicated the IS was an independent prognostic factor. In addition, the lower IS related to higher expression of ICPs and neoantigen load. Conclusions The identification of IS in cervical cancer tissues could facilitate patient risk stratification and selection of immunotherapeutic responses, but more prospective studies are needed to assess its reliability.

Objective To identify the anatomic advantages of pre-contouring long helical plate of proximal humerus internal locking system (PHILOS) aided by 3D-printing technique in minimally invasive plate oseoynthesis (MIPO) for metadiaphyseal fractures of the proximal humerus.Methods Firstly in a cadaveric study,12 fresh frozen samples of upper extremity were divided into 2 equal groups:6 in a Synbone group and 6 in a 3D-printing group.Long 10-hole PHILOS plates were pre-contoured helically according to Synbone humerus models in the Synbone group but according to 3D-printing humerus models in the 3D-printing group.All these helical plates were fixed onto the cadaveric humerus using MIPO technique respectively.The horizontal distances between the radial nerve and the lateral side of the plate were measured at the point where the radial nerve penetrates the muscular septum,at the 6th hole on the plate and at the distal end of the plate;the distance between the medial side of the distal plate and the upper arm neurovascular bundle was also measured.Finally,the full lengths of all these cadaveric humeri were measured.Secondly,on the basis of the anatomic study,16 patients with metadiaphyseal fracture of the proximal humerus were treated at Department of Orthopedic Surgery,The Sixth People's Hospital of Shanghai from February 2013 to March 2016,using the same MIPO technique and the same long 10-hole PHILOS plates pre-contoured helically on the 3D printing models which were mirrored on the humerus on the healthy side of the patients.They were 4 men and 12 women,aged from 59 to 87 years (mean,71.0 years).By the AO/OTA classification,10 cases were type B and 6 type C.The fracture line involved the proximal humerus in 7 cases.Postoperative complications were followed up.At the final follow-up,the shoulder function was assessed according to the Constant-Murley score and the elbow function according to the Mayo Elbow Performance Score (MEPS).Results By the anatomic measurement,the full length of cadaveric humerus averaged 30.17 ± 1.93 cm in the Synbone group and 29.75 ± 2.17cm in the 3D-printing group,showing no significant difference (P ＞ 0.05).The horizontal distances between the radial nerve and lateral side of the plate at the point where the radial nerve penetrates the muscular septum,at the 6th hole on the plate and at the distal end of the plate in the Synbone and 3D-printing groups were,respectively,11.50 ± 0.92 mm versus 17.87 ± 1.88 mm,6.90 ± 1.78 mm versus 14.83 ± 1.50 mm,and 5.14 ± 1.14 mm versus 8.36 ± 1.27 mm,all showing significant differences between the 2 groups (P ＜ 0.05％).The distance between the medial side of the distal plate and the upper arm neurovascular bundle was 6.25 ± 0.95 mm in the Synbone group and 6.88 ± 1.21 mm in the 3D-printing group,showing an insignificant difference between the 2 groups (P ＞ 0.05).The clinical observation found no iatrogenic nerve injury.The 16 patients were followed up for an average of 25.3 months (range,from 24 to 38 months).All fractures got united uneventfully.At the final follow-up,their Constant-Murley scores averaged 77.6 points and their MEPS 96.5 points.Conclusion The risk of iatrogenic injury to the radial nerve can be lowered when 3D-print technique is applied for helical pre-contouring of long PHILOS plate in the MIPO for metadiaphyseal proximal humeral fractures,leading to satisfactory clinical results.

OBJECTIVE:To observe the clinical efficacy and safety of recombinant human endostatin (rh-endostatin) combined with Lobaplatin for injection and irinotecan injection in the treatment of advanced recurrent small cell lung cancer (SCLC). METHODS:A total of 88 patients with advanced recurrent SCLC in our hospital were divided into control group (41 cases) and observation group (47 cases) according to random number table. Control group was given Irinotecan injection+Lobaplatin for injection. Observation group was additionally given Recombinart human endostatin injection 15 mg added into 0.9%Sodium chloride injection 250 mL,ivgtt,qd,for consecutive 14 d,every 14 d. A treatment course lasted for 28 d,and both groups were treated for 2 courses. The clinical efficacy,the levels of serum carcinoembryonic antigen(CEA),the scores physical state (ECOG) and quality of life (QOL) before,after treatment were observed in the two groups,and the survival and adverse reactions of the two groups were compared. RESULTS:The total response rate of observation group was 59.6%,which was higher than 43.9% of control group,but there was no statistical significance (P>0.05). Before treatment, there was no significant difference in serum CEA levels,ECOG scores or QOL scores,between 2 groups(P>0.05);after treatment,the serum CEA levels of the two groups were significantly decreased,and the observation group was significantly lower than the control group,with statistically significant (P<0.05). In observation group,ECOG scores decreased while QOL scores increased significantly,and significantly better than the control group,with statistical significance(P<0.05). The overall survival(OS)of observation group was 16.8 months,which was significantly higher than 11.5 months of control group,with statistical significance (P<0.05). The incidence of leucopenia in observation group was significantly higher than control group;the incidence of leucopenia and abnormal liver function were significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Rh-endostatin injection combined with lobaplatin and irinotecan can improve serum CEA levels and the quality of living aswell as prolong the survival time.