BACKGROUND:It has been found that internal factors such as anatomical structure,hormone level and neuromuscular function of athletes are closely related to the risk of anterior cruciate ligament injuries,and external factors such as the material of the playing field also become one of the risk factors affecting the occurrence of non-contact anterior cruciate ligament injuries,but they are relatively under-attended in the current studies. OBJECTIVE:To explore effects of artificial turf versus natural grass on the biomechanical performance of the lower limbs in young females during jump-landing. METHODS:According to the test needs,artificial turf and natural grass in accordance with the standards of GB/T 20033.3-2006 and GB/T 19995.1-2005 were leveled and fixed on two three-dimensional force measuring platforms.Twenty-one young females were voluntarily recruited and completed the jump-landing task on the artificial turf and natural grass.Subjects stood on the steps and then jumped forward,jumped down to the force measuring platform and immediately jumped with full force to the force measuring platform again.The two landings were required to fall to the two force measuring platforms,and the whole jumping action was considered successful without any pause.The kinematic,kinetic and electromyographic data of the lower limbs during the landing process were collected synchronously to compare and analyze the differences between the two. RESULTS AND CONCLUSION:In terms of kinetics,posterior and vertical ground reaction force at the initial landing moment during jump-landing on the natural grass were significantly lower than those on the artificial turf(P＜0.05,P＜0.01),as well as at the peak ground reaction force moment(P＜0.05,P＜0.05).Additionally,the knee flexion moment when jump-landing on the natural grass was higher than that on the artificial turf(P＜0.01).In terms of electromyography,within 100 ms after the initial landing moment,the electromyography activity levels of medial femoris muscle,lateral femoris muscle and anterior tibialis muscle when jump-landing on the natural grass were significantly lower than those on the artificial turf(P＜0.05,P＜0.01,P＜0.05).To conclude,compared with the natural grass,jump-landing on the artificial turf leads to an change in biomechanical performance that will cause an increase in anterior cruciate ligament tension.

ObjectiveTo investigate the influence of empagliflozin combined with donafenib or lenvatinib on the pharmacokinetic parameters of each drug， and to provide a reference for combined medication in clinical practice. MethodsA total of 48 healthy male Sprague-Dawley rats were divided into 8 groups： empagliflozin group 1 and 2， donafenib group， lenvatinib group， donafenib pretreatment+empagliflozin group， lenvatinib pretreatment + empagliflozin group， empagliflozin pretreatment+donafenib group， and empagliflozin pretreatment+lenvatinib group， with 6 rats in each group. The doses of empagliflozin， donafenib， and lenvatinib were 2.5 mg/kg， 40 mg/kg， and 1.2 mg/kg， respectively. The rats in the empagliflozin group， donafenib group， and lenvatinib group were given a blank solvent by gavage for 7 consecutive days， followed by a single dose of empagliflozin， donafenib， or lenvatinib on day 7 after the administration of the blank solvent； the rats in the pretreatment groups were given the pretreatment drug by gavage for 7 consecutive days， followed by a single dose of drug combination on day 7 after administration of the pretreatment drug. Blood samples were collected at different time points， and plasma was separated to measure the concentration of each drug. A validated ultra-performance liquid chromatography-tandem mass spectrometry method was used to measure the plasma concentrations of donafenib， lenvatinib， and empagliflozin， and a non-compartmental model was used to calculate the main pharmacokinetic parameters of each drug （area under the plasma concentration-time curve ［AUC］， time to peak ［T_max］， peak concentration ［C_max］， and half-life time ［t_1/2］）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. ResultsCompared with the empagliflozin group， the donafenib pretreatment+empagliflozin group had significant increases in the AUC_0-t and AUC_0-∞ of empagliflozin （P=0.011 and 0.008）， while the lenvatinib pretreatment+empagliflozin group had no significant change in the AUC of empagliflozin， with a slightly shorter T_max （P=0.019）. Compared with the donafenib group， the empagliflozin pretreatment+donafenib group had significant increases in the AUC_0-t and AUC_0-∞ of donafenib （P=0.027 and 0.025）， as well as a significant increase in C_max （P=0.015） and significant reductions in CLz/F and Vz/F （P=0.005 and 0.004）； compared with the lenvatinib group， the empagliflozin pretreatment+lenvatinib group had a reduction in the t_1/2 of lenvatinib by approximately 5 hours （P=0.002）， with a trend of reduction in AUC_0-t （P0.05）. ConclusionEmpagliflozin combined with donafenib may alter the pharmacokinetic parameters of both drugs， leading to a significant increase in the exposure levels of both drugs， and efficacy and adverse reactions should be monitored during co-administration. There are no significant changes in the exposure levels of empagliflozin and lenvatinib during co-administration.

ObjectiveTo explore the possible mechanisms of Shoutai Wan （寿胎丸） in treating recurrent miscarriage （RSA） from the perspective of immune tolerance under the acidic microenvironment at the maternal-fetal interface. MethodsFemale CBA/J mice were randomly divided into normal group， model group， progesterone group， and Shoutai Wan group， with 15 mice in each group. The mice in the normal group and model group were given 0.2 ml distilled water by gavage each day， the Shoutai Wan group given Shoutai Wan decoction 0.15 g/（10 g·d） by gavage， the progesterone group given progesterone tablets 0.44 mg/（10 g·d） by gavage. After gavage for 14 days， the mice were cohabited. Female CBA/J mice in the normal group were mated with male BALB/c mice at a ratio of 2∶1， and female CBA/J mice in the other groups were mated with male DBA/2 mice at a ratio of 2∶1 to establish the RSA mouse model. Vaginal smears were taken from the female mice the next morning， and the appearance of a large number of spermatozoa and the presence of a vaginal plug were considered as the first day of pregnancy. After the appearance of the plug， the mice were continued to be administered according to the previous method until the 10th day of pregnancy. On the 10th day of pregnancy， maternal-fetal interface tissues were collected from each group of mice， and lactate dehydrogenase colorimetric method was used to detect lactate （LA） content； qPCR method and Western blot method were used to detect the expression of immune-related factors interleukin-4 （IL-4）， interferon-gamma （IFN-γ）， transforming growth factor beta 1 （TGF-β1）， and forkhead box protein 3 （Foxp3） mRNA and protein； flow cytometry was used to detect the numbers of helper T lymphocyte 1 （Th1）， helper T lymphocyte 2 （Th2）， regulatory T cell （Treg）， classical macrophage （M1）， and alternative macrophage （M2）. The bivariate Pearson test was used to analyze the correlation between LA content and the numbers of Th1， Th2， Treg， M1， and M2 cells， as well as the correlation between LA content and the expression of IL-4， IFN-γ， TGF-β1， Foxp3 protein， and mRNA. ResultsOn the 10th day of pregnancy， compared with the normal group， the LA content decreased in the model group， and the expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues decreased， while the expression of IFN-γ protein and mRNA increased. The numbers of Th1 and M1 cells increased， while the numbers of Th2， Treg， and M2 cells decreased （P＜0.05 or P＜0.01）. Compared with the model group， the LA content increased in the Shoutai Wan group and progesterone group. The expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues increased， while the expression of IFN-γ protein and mRNA decreased. The numbers of Th1 and M1 cells decreased， while the numbers of Th2， Treg， and M2 cells increased （P＜0.05 or P＜0.01）. The LA content was positively correlated with the numbers of Th2， Treg， and M2 cells， and the expression of IL-4， TGF-β1， Foxp3 protein， and mRNA （P＜0.05 or P＜0.01）； the LA content was negatively correlated with the numbers of Th1， M1 cells， and the expression of IFN-γ protein and mRNA （P＜0.05 or P＜0.01）. ConclusionShoutai Wan may improve immune tolerance by regulating the expression of immune-related factors in the acidic microenvironment at the maternal-fetal interface of RSA model mice， thereby exerting its role in preventing miscarriage.

Background Diurnal temperature range (DTR) is closely associated with cardiovascular health in the elderly, but there is a lack of research on the relationship between DTR and ischemic heart disease (IHD) in the elderly. Objective To investigate the effect of DTR on daily hospital admissions for IHD in people 65 years and older in Wuhan. Methods The study obtained data on elderly inpatients with IHD from all secondary and tertiary hospitals in Wuhan between January 1, 2017 and December 31, 2018, along with synchronous meteorological and air pollution data. Daily DTR was calculated as the difference between the maximum and minimum temperatures in a day. We employed distributed lag nonlinear models based on quasi-Poisson distribution to analyze the association between DTR and hospitalization risk in individuals aged 60 years and above. We assessed the extreme effects of DTR by selected DTR percentiles (the 1st percentile, P₁: 1.8 ℃; the 5th percentile, P₅: 2.9 ℃; the 95th percentile, P₉₅: 14.3 ℃; and the 99th percentile, P₉₉: 16.2 ℃) on hospitalization for IHD in the elderly population. Additionally, we conducted stratified analyses by gender, age (60-74 years and ≥75 years) and different subtypes (acute IHD and chronic IHD) to investigate the effects of DTR on hospitalizations for IHD across different genders, ages, and subtypes. Results This study included a total of 64212 first-time IHD hospitalizations among individuals aged 65 years and above in Wuhan from 2017 to 2018. The results showed a "J"-shaped exposure-response relationship between DTR and the cumulative risk of IHD hospitalization with a lag of 7 d; the optimal DTR was 5.0 ℃, and as DTR increased or the lag time lengthened, the risk of hospitalization for IHD in the elderly population increased. Extremely high DTR (P₉₉: 16.2 ℃) had a significant impact on the day of exposure (lag 0), with a cumulative RR of 1.58 (95%CI: 1.25, 1.99) at a lag of 7 d. The overall effects of DTR on IHD for different genders, ages, and subtypes of IHD exhibited similar patterns to the effects for overall population. High DTR had a significantly higher impact on hospitalization for chronic IHD (RR=1.46, 95%CI: 1.20, 1.79), compared to acute IHD (RR=1.29, 95%CI: 1.04, 1.61). At a cumulative lag of 7 d, elderly individuals aged 60-74 (RR=1.78, 95% CI: 1.30, 2.42) were more affected by high DTR in terms of IHD hospitalizations compared to those aged ≥75 (RR=1.35, 95% CI: 1.08, 1.70). Conclusion High DTR significantly increases the risk of hospitalization for IHD among elderly individuals. The effect of high DTR is particularly pronounced in patients with chronic IHD and elderly individuals aged 60–74 years.

Objective To explore the effect of LIMK1 on the progression of cervical cancer(CC).Methods HeLa and C-33A human cervical cancer cells overexpressing LIMK1 were established and injected subcutaneously into nude mice.The tumor volume was measured and expression of NOX2,NOX4,p-Src,p-RUNX3,RUNX3,and MMP-9 proteins in tumor cells was detected by Western blot assays.LIMK1-overexpressing HeLa and C-33A cells were cultured in 5％O2 with antioxidants.The protein expression of LIMK1,NOX4,p-Src,p-RUNX3,RUNX3 and MMP-9 in the cells was detected by Western blot assays.Cell migration was assessed by a scratch assay.Transwell assays were used to assess cell migration and invasion.A monoclonal proliferation assay was used to assess cell proliferation.Results The tumor volume in nude mice injected with LIMK1-overexpressing HeLa cells was increased significantly,and NOX2,NOX4,p-Src,p-RUNX3 and MMP-9 protein levels were increased,while RUNX3 protein expression was decreased.In LIMK1-overexpressing HeLa and C-33A cells,the protein expression of LIMK1,NOX4,p-Src,p-RUNX3,and MMP-9 was increased,RUNX3 protein expression was decreased,and cell migration,invasion,and proliferation were increased.However,after adding antioxidants,the expression levels of NOX4,p-Src,p-RUNX3,RUNX3 and MMP-9 proteins,and cell migration,invasion,and proliferation were not different from those of control cells.Conclusions LIMK1 promotes the progression of cervical cancer by enhancing the ROS/Src pathway,thereby promoting the migration,invasion,and proliferation of cervical cancer cells.

Objective:Development and validation of a nomogram for predicting the 4-year incidence of type-2 diabetes mellitus (T2DM) in a Chinese population was attempted.Methods:This prospective cohort study was conducted in Shijingshan District Pingguoyuan Community (Beijing, China) from December 2011 to April 2012 among adults aged≥40 years not suffering from T2DM. Finally, 8 058 adults free of T2DM were included with a median duration of follow-up of 4 years. Participants were divided into a modeling group and verification group using simple random sampling at a ratio of 7∶3. Univariate and multivariate Cox proportional risk models were applied to identify the independent risk predictors in the modeling group. A nomogram was constructed to predict the 4-year incidence of T2DM based on the results of multivariate analysis. The Concordance Index and calibration plots were used to evaluate the differentiation and calibration of the nomogram in both groups.Results:A total of 5 641 individuals were in the modeling group and 2 417 people were in the validation group, of which 265 and 106 had T2DM, respectively, at 4-year follow-up. In the modeling group, age ( HR=1.349, 95% CI 1.011-1.800), body mass index ( HR=1.347, 95% CI 1.038-1.746), hyperlipidemia ( HR=1.504, 95% CI 1.133-1.996), fasting blood glucose ( HR=4.189, 95% CI 3.010-5.830), 2-h blood glucose level according to the oral glucose tolerance test ( HR=3.005, 95% CI 2.129-4.241), level of glycosylated hemoglobin ( HR=3.162, 95% CI 2.283-4.380), and level of γ-glutamyl transferase ( HR=1.920, 95% CI 1.385-2.661) were independent risk factors for T2DM. Validation of the nomogram revealed the Concordance Index of the modeling group and validation group to be 0.906 (95% CI 0.888-0.925) and 0.844 (95% CI 0.796-0.892), respectively. Calibration plots showed good calibration in both groups. Conclusion:These data suggest that our nomogram could be a simple and reliable tool for predicting the 4-year risk of developing T2DM in a high-risk Chinese population.

【Objective】 To explore the relationship between chronic comorbidity and the physical and mental health of relatives of elderly people during the nursing home confinement, and to analyze the mediating effects of perceived stress and intolerance of uncertainty in this context. 【Methods】 A total of 568 family members of elderly people in nine elderly institutions in Shaanxi Province were selected. The survey included the short version of the Perceived Stress Scale, Intolerance of Uncertainty Scale, and The World Health Organization-5 Well-being Index. The data were analyzed with Stata for correlation and mediation effects. 【Results】 ① The comorbidities of chronic diseases was positively correlated with the perceived stress (r=0.16, P<0.001) and intolerance of uncertainty (r=0.11, P=0.006) of the family members, but negatively correlated with the physical and mental health of the family members (r=-0.13, P=0.002). ② The mediating effect of perceived stress between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.023, accounting for 18.8% of the total effect; the mediating effect of intolerance of uncertainty between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.041, accounting for 33.5% of the total effect. 【Conclusion】 During closed management in a nursing facility, the physical and mental health of family members of older adults with chronic co-morbidities is poorer than that of family members of non-chronic co-morbidities. And it can lead to a decline in physical and mental health of family members through increased perceived stress and intolerance of uncertainty.

Primary hemifacial spasm is a motor disorder of facial muscles related to facial nerve. During the attack, the facial muscles present irregular and involuntary clonus, which can be induced or aggravated by emotional excitement, mental tension and random facial movement, seriously affecting daily work and life. The pathogenesis, diagnosis, differential diagnosis and treatment of the primary hemifacial spasm have been studied extensively in recent years. This article reviews the progress in these aspects.

Objective:To analyze the clinical characteristics of fulminant type 1 diabetes (FT1DM) in China.Methods:Clinical data of 279 cases related to FT1DM in Chinese Database from January 2005 to December 2018 were collected, and other 20 patients from our hospital were included in the present study.Results:(1) There has been a progressive increasing in the number of reported cases every year in China, and the number in the southern region were significantly more than that in the northern region. (2) The median age of the onset of FT1DM patients in China was 32.5 years old, without significant gender difference. Moreover, 36.5% (54/148) of the female patients caught the disease during their prenatal period, most of them were onset in the second or third trimesters of pregnancy and 2 weeks after delivery (37/40), and the prognosis of the fetus was extremely poor. (3) Compared with new-onset type 1 diabetes, FT1DM patients were younger, and with higher blood glucose [(39.7±15.3) vs (21.2 ± 9.9) mmol/L], higher serum creatinine [(188.4±115.9) vs (51.8 ±23.1) μmol/L], and higher amylase levels [245.5 (26.0-5 137.0) vs 54.7 (14.0-404.9) U/L]. FT1DM patients were with more severe acidosis, and lower HbA 1C level [(6.6 ±0.8)% vs (12.9 ± 2.5)%, P<0.01]. (4) FT1DM patients may combine with multiple organ dysfunction or severe metabolic disorders, electrolyte disorders, as well as liver and kidney dysfunctions, and elevation of amylase and muscle enzymes. Conclusion:FT1DM are with some clinical characteristics different from classic new-onset type 1 diabetes, including adult-onset, frequent in the southern China. Pregnancy may be a predisposing factor for female patients. Significant metabolic disorders and multiple organ involvements are common in the patients with FT1DM.

Objective:To explore the clinical pathological characteristics and initial 131I curative responses of familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC). Methods:A total of 66 FDTC patients (19 males, 47 females, age (39.8±11.7) years) and 1 701 SDTC patients (442 males, 1 259 females, age (40.9±11.3) years) who underwent 131I therapy in Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2010 and August 2018 were retrospectively enrolled. The clinical pathological characteristics, preablative stimulated thyroglobulin (ps-Tg), preablative stimulated thyroglobulin antibody (ps-TgAb) and response to initial therapy (excellent response, indeterminate response, biochemical incomplete response, structural incomplete response) of two groups were analyzed and compared. The clinical pathological parameters included age, gender, pathological type, tumour maximum diameter, bilateral, multifoci, nodules goiter, thyroiditis, thyroid membrane invasion, lymph node metastasis (LNM), invasion of the surrounding soft tissues, distant metastasis, TNM staging and American Thyroid Association (ATA) risk stratification (low-risk, intermediate-risk, high-risk). χ2 test or Fisher exact test and independent-sample t test were used to compare the data between two groups. Results:Comparing with SDTC group, FDTC group showed higher proportion of bilateral foci (45.5%(30/66) vs 31.2%(530/1 701); χ2=5.999, P=0.010), thyroid membrane invasion (43.9%(29/66) vs 26.6%(452/1 701); χ2=9.672, P=0.002) and distant metastasis (15.2%(10/66) vs 6.2%(105/1 701); χ2=8.418, P=0.004). There was a statistical difference in risk stratification between two groups (high-risk: 18.2%(12/66) vs 9.2%(156/1 701); intermediate-risk: 68.2%(45/66) vs 72.7%(1 237/1 701); low-risk: 13.6%(9/66) vs 18.1%(308/1 701); χ2=6.898, P=0.030). But the tumor maximum diameter of FDTC group was smaller than that of SDTC group ((1.24±0.74) vs (1.50±0.92) cm; t=-2.275, P=0.020). There were no significant differences in other clinical pathological parameters between FDTC group and SDTC group ( t=-0.804, χ2 values: 0.101-5.359, all P>0.05). There were no significant differences between two groups in the postoperation ps-Tg, ps-TgAb levels and the response to initial therapy after 131I treatment ( χ2 values: 0.059-1.915, all P>0.05). Conclusions:The FDTC group displays distinct characteristics as increased aggressiveness at diagnosis. But after accurately treatment, there is no significant difference in the response to therapy between two groups.