Objective: To evaluate the 4-year clinical outcomes of patients following Firesorb bioresorbable scaffold (BRS) implantation. Methods: The study reported the 4-year follow-up results of the FUTURE I study. FUTURE I was a prospective, single-center, open-label, first-in-man study which evaluated the feasibility, preliminary safety, and efficacy of Firesorb stent in the treatment of coronary artery stenosis. A total of 45 patients with single de novo lesions in native coronary arteries ,who hospitalized in Fuwai Hospital from January to March 2016 were enrolled. After successfully stent implantation these patients were randomized in a 2∶1 ratio into cohort 1 (n=30) or cohort 2 (n=15). The patients in cohort 1 underwent angiographic, IVUS or OCT examination at 6 months and 2 years; and cohort 2 underwent angiographic, IVUS or OCT at 1 and 3 years. All patients underwent clinical follow-up at 1, 6 months and 1 year and annually thereafter up to 5 years. The primary endpoint was target lesion failure (TLF, including cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization). Secondary endpoints included patient-oriented composite endpoint (PoCE, defined as composite of all death, all miocardial infarction, or any revascularization). Results: A total of 45 patients were enrolled and implanted with Firesorb BRS, including 35 males (77.8%), and the age was (54.4±9.3) years. At 4 years, 10 patients in cohort 1 were reexamined by coronary angiography and OCT examination. Among them, 2 patients' stents were completely degraded and absorbed. Compared with the OCT images of the other 8 patients in cohort 2 at 3 years, the degree of stent degradation was increased, and no stent adherence was found. The 4-year clinical follow-up rate was 100%. In 4-year clinical following up, 2 patients suffered PoCE (4.4%): 1 patient underwent non-target vessel revascularization the day after index procedure and target vessel revascularization (Non-target lesion revascularization) at 2-year imaging follow-up; the other patient underwent target lesion revascularization during imaging follow-up at 4 years but not due to ischemic driven. There was no scaffold thrombosis or TLF events through 4 years. Conclusions: Four years after the implantation, complete degradation and absorption of the Firsorb stent are evidenced in some patients. Firesorb stent is feasible and effective in the treatment of patients with non-complex coronary lesions.
Absorbable Implants ; Cardiovascular Agents ; Coronary Artery Disease/surgery* ; Drug-Eluting Stents ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Prospective Studies ; Sirolimus ; Treatment Outcome

Objective To systematically analyze the framework and core content of physical activity inclusive school health policies. Methods This study conducted systematic content analysis of key messages of WHO key documents related to physical activity and school health services, and constructed policy and research framework. WHO's key policy documents in the field of school health included: Making Every School a Health-Promoting School Implementation Guidelines, WHO Guidelines on School Health Services, and the Global Criteria and Indicators for Making Every School a Health-Promoting School, and the key documents in the field of physical activity mainly include Global Action Plan for Physical Activity Promotion 2018-2030: Strengthening Physical Activity for a Healthy World, and WHO Guidelines on Physical Activity and Sedentary Behavior (Children and adolescents). Results Physical activity, as a health strategy and development strategy, is one of the most important tools for achieving health-promoting schools. In the area of health and education, the key to building health-promoting schools is to focus on child functioning and development, with the goal of promoting healthy inclusion and equity in schools. In the school setting, physical activity for children and adolescents is integrated into the school health service continuum with a focus on health promotion. At the macro level, the state and relevant authorities should establish a strategic structure and strategic planning for the integration of physical activity into the school health service system. At the meso level, educational institutions should develop and improve school health service policies and programs, and improve school health service tools based on the requirements of WHO school health service guidelines. Child health services are achieved through the provision of high-quality physical education programs and after-school physical activities. At the micro level, guided by global standards for building health-promoting schools, physical activity is promoted in the form of lessons and activities for healthy child development. Integrating physical activity into the school health service system can be done in six areas: school health leadership and governance, school infrastructure funding, school health service delivery that supports physical activity, human resources for school health, school health-related medicine and technology, and school health information system. We need to implement health-promoting school policies, strengthen multi-level school leadership and governance, raise the necessary funds to develop human resources adapted to the construction of health-promoting schools and build programs to support physical activity. Conclusion School health service is an important area for promoting children's health and achieving the UN 2030 Sustainable Development Goals, and physical activity is an important strategy of school health services. Policy documents issued by WHO construct the integration of physical activity into the policy framework of the school health service system, of which the core component is to integrate physical activity into the health-promoting school with educational and physical activity approaches. According to the WHO six building blocks of health service system, the integration of physical activity into the school health requires strengthening school health leadership and governance, improving school infrastructure financing, developing school health human resources, developing school-based health-related medical technologies, and establishing a health information system for sharing student health data.

Objective To explore the theories, content and approaches of integrating physical activity in children's eye health service system in the context of health services. Methods From the perspectives of six building blocks of WHO health system, namely, leadership and governance, financing, human resources for health, service delivery, medical technology, and health information system, we analyzed the policy framework and key contents related to school-based eye health and physical activity, and explored how to promote the implementation of physical activity into the school-based eye health service system, and the integration of physical activity into the eye health continuum: prevention, intervention, rehabilitation, and health promotion. Results In perspective of health system, the integration of physical activity into school-based eye health services should be in accordance with the five principles of cross-cutting health services, namely, universal accessibility and equity, human rights, evidence-based, life-span, and empowerment. According to the World Vision Report, WHO advocates to build a person-centered eye health service system, and person-centeredness is the core concept of the new model of school-based eye health services and physical activity integration. WHO advocates a school-based approach to education and physical activity in health-promoting schools to promote student health, physical activity as a preventive, interventional, rehabilitation and health promotive measure related to children's eye health, and vigorously train professionals within schools who have knowledge and skills related to physical activity and eye health, build an information system on physical activity and children's eye health, and promote the integration of physical activity into the school-based eye health service system. Conclusion Physical activity is an important measure to promote children's eye health and an important component to achieve a person-centered eye health service system. Based on the six building blocks of the WHO health service system, a school-based eye health service that integrates a theoretical and methodological system of physical activity is constructed, requiring the provision of health promotion methods such as education and physical activity in the school setting, to enhance leadership and governance of eye health services based on educational and physical activity approaches in the school setting, establish new funding mechanisms, provide financial security, develop human resources related to physical activity for eye health, improve related service delivery systems, develop high-quality physical activity intervention eye health techniques and equipment, and integrate information on children's physical activity and eye health into school health information systems to achieve children's eye health and promote their physical and mental development.

Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

Mitochondria, which play an important role in cell metabolism, stress response and cell death, are the key organelles that regulate the energy balance of cells. Under the influence of internal and external environment, damaged or senescent mitochondria pose a serious threat to cell survival. Mitophagy refers to the selective elimination of dysfunctional mitochondria to maintain the homeostasis of the intracellular environment. FUN14 domain containing 1 (FUNDC1) is a newly discovered mitophagy receptor protein, which plays an important regulatory role in mediating mitophagy. This paper mainly reviews the recent research progress of FUNDC1 regulation mechanism and its pathophysiological significance in mitophagy.

Results and Conclusion:The core diagnostical terms of communication disorder for children include Primary Pragmatic Language Impairment of Developmental Language Disorder, Communication, Communicating-Receiving, and Communicating-Production, etc. Communication disorder is a typical disorder of limited social interaction and a typical manifestation of developmental retardation for children, named Developmental Language Disorder Main Companion Pragmatic Language Impairment (6A01.22), subclass of Developmental Language Disorder (6A01). Communication disorders involve in speech-related body structures and functions, activity and participation, environmental factors and personal factors; such as communication (d3), including communicating-receiving (d310-d329), communicating-production (d330-d349), conversation and use of communication devices and techniques (d350-d369), and health-related behaviors. The structured framework of rehabilitation intervention involves in body function and structure, activity and participation, environmental factors and personal factors; includes assessment, training and treatment, educational counseling, and psychological and social support. Objective:To explore the definition and core terminology of communication disorders for children, establish the diagnostic criteria and functional assessment criteria of communication disorder, and develop a holistic rehabilitation solution for it based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (Children and Youth version) (ICF-CY) and International Classification of Health Interventions (ICHI). Methods:Core definition and terminology of communication disorder were analysed with ICD-11, American Speech-Language-Hearing Association (ASHA) and Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V). The diagnostical criteria of communication disorders for children were analyzed using the ICD-11. The functioning diagnostical criteria of communication disorders for children were explored using ICF-CY. A holistic rehabilitation solution was developed based on ICF-CY and ICHI.

Objective To investigate the clinical features of elderly patients with stage 3-4 chronic kidney disease ( CKD ) and to analyze the risk factors of the kidney function progression. Methods This was a cross-sectional study. The clinic data of elderly patients (≥60 years) with stable clinical manifestation in Beijing Hospital from January ,2014 to December ,2015 was collected.Based upon the eGFR derived from Cockcroft-Gault (CG) equation ,all patients were divided into groups of CKD 3a group ,CKD 3b group and CKD 4 group ,respectively. Moreover ,patients were separated into the old group (＜ 80 years) and the very old group (≥80 years) based on the age. The demographic features ,primary diseases history ,body mass index (BMI) ,blood routine ,urine routine , blood biochemistry ,Cystatin C and iPTH were recorded.Logistic regression analysis of kidney function progression was also conducted. Results One-hundred and eighty-three cases were enrolled with a mean age of(80 ± 9)years.Along with the descent of kidney function ,the age ,levels of proteinuria and iPTH gradually ascended (F＝ 12.352 ,5.910 ,5.910 ;P＝ 0.000 ,0.003 ,0.003 ,respectively) and the BMI and serum albumin gradually descended (F＝9.758 ,11.088 ;P＝0.000 ,0.000 ,respectively).In addition ,compared to the old group ,very old group was associated with decreased level of eGFR [(37.1 ± 9.9) ml·min－1·1.73 m －2vs. (44.0 ± 12.0) ml·min－1·1.73 m －2,t＝ －4.280 ,P＝0.000] and increasedlevelofCystatinC[(1.71±0.84)mg/L vs. (1.40±0.69)mg/L ,t＝3.484 ,P＝0.001].The Logistic regression analysis indicated that the proteinuria was an independent risk factor for the progression of kidney function ( OR ＝3.856 ,P＝0.004). Conclusions As the gradually descended of the eGFR level in elderly patients with stage 3-4 CKD ,age ,proteinuria and iPTH gradually ascended ,BMI and serum albumin descended ,respectively. The level of eGFR decreased and CystatinC increased significantly with the increasing age. Proteinuria was an independent risk factor for progression of the kidney function.

Thirteen novel oleanolic acid (OA) derivatives were designed and synthesized with modification at positions of C-3, C-12 and C-28 of OA. Their structures were confirmed by MS, 1H NMR and elemental analysis. Their in vitro cytotoxicities against various cancer cell lines (SGC7901, MCF-7 and A549) were evaluated by MTT assay. The results indicated that the tested derivatives were found to have stronger cell growth inhibitory activity than OA. Among them, compounds II2 and II3 showed more potent cytotoxicity on MCF-7 and A549 tumor cells than gefitinib (positive control). They are worthy to be studied further.
Antineoplastic Agents, Phytogenic ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Drug Design ; Humans ; Oleanolic Acid ; chemical synthesis ; pharmacology

OBJECTIVETo observe the effect of Tongsaimai (TSM) tablets in treating foot trauma of diabetic foot (DF) model rats, and discuss its potential mechanism.

METHODMale SD rats were selected to duplicate the diabetic foot ulcer model and randomly divided into the blank control group, the model group, the metformin treatment group, and TSM 12.44, 6.22, 3.11 g x kg(-1) groups (n = 10). The healing of ulcer wounds were observed on day 1, 4, 8, 13 and 18. After 18 days, a histopathologic examination was conducted for ulcer tissues. The contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected by hydroxylamine and TBA methods. The content of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were determined with the radioimmunoassay. The immunohistochemical method was used to observe the expression of vascular endothelial growth factor (VEGF) in ulcer tissues and the number of capillary vessels.

RESULTTSM could alleviate the pathological changes of diabetic foot rats, accelerate the ulcer healing on 4, 8, 13, 18 d, reduce MDA, IL-6, TNF-alpha, VEGF content in rat serum at 18 d (after the rehabilitation period), and enhance the SOD content. Specifically, the TSM 12.44 g x kg(-1) group showed significant differences compared with the model group (P < 0.05, P < 0.01). At 18 d after the treatment (the late rehabilitation period), the VEGF expression of TSM 12.44, 6.22 g x kg(-1) groups and the number of blood capillaries of the TSM 12.44 g x kg(-1) group were significantly lower than that of the model group (P < 0.05, P < 0.01).

CONCLUSIONTSM could promote the foot wound healing of DF model rats, reduce MDA, IL-6 and TNF-alpha levels in serum, increase the SOD content and decrease the VEGF expression and the number of blood capillaries in the late rehabilitation period. Its action mechanism may be related to the inhibition of oxidative stress injury and the inflammatory cell infiltration.

Animals ; Diabetic Foot ; drug therapy ; genetics ; metabolism ; physiopathology ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Interleukin-6 ; genetics ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; genetics ; metabolism ; Tablets ; administration & dosage ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Wound Healing ; drug effects