Objective·To explore the effect of a prehospital multimodal prehabilitation program on the preoperative functional status and postoperative recovery of patients with gastrointestinal malignant tumors.Methods·A total of 78 patients with gastrointestinal malignant tumors,hospitalized in Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine from June to December 2023,were enrolled.They were divided into the standard group(SD group,n=40)and the prehospital multimodal prehabilitation group(PMP group,n=38)by using random number table.From the time the operation was agreed upon by both the doctor and patient to the day before the operation,the SD group followed the routine preoperative guidance,while the PMP group received a home-based prehospital multimodal prehabilitation program.The general data of patients were collected,and the six-minute walk distance(6MWD)was compared between the two groups at baseline and on the day before operation.The length of postoperative hospitalization,time to first flatus,time to first ambulation,time to first oral intake,drainage removal time and postoperative complication rate were also compared between the two groups.Results·There was no difference in general data and duration of preoperative intervention of patients between the two groups.At baseline,there was no significant difference in 6MWD between the two groups.On the day before operation,the 6MWD in the PMP group was higher than that in the SD group(P=0.016).Changes in 6MWD in the PMP group were significantly higher compared to SD group during the preoperative period,with values of(23.42±13.59)m vs.(-3.75±12.08)m(P＜0.001).Time to first flatus,time to first ambulation and time to first oral intake in the PMP group were earlier than those in the SD group(P＜0.05).However,there was no significant difference in drainage removal time,postoperative hospitalization and postoperative complication rate between the two groups(P＞0.05).Conclusion·Prehospital multimodal prehabilitation can improve the preoperative function and accelerate the postoperative recovery in patients with gastrointestinal malignancies.

Objective: To understand the sedentary behavior level of children and adolescents with intellectual disabilities in Jinan City, and to provide a reference basis for developing health behavior intervention strategies. Methods: By used the method of cluster random sampling,the Children s Leisure Activities Study Survey was used to investigate the sedentary behavior level of 285 children and adolescents with intellectual disabilities aged 6-18 years from 7 special education schools in Jinan City. Results: The sedentary behavior time during the whole week among children and adolescents with intellectual disabilities in Jinan City was 394.46 min/d, including 378.00 min/d on weekdays(Monday to Friday) and 388.80 min/d on weekends (Saturday and Sunday), the difference was statistically significant ( Z =-2.19, P <0.05). 80.4%(229) of children and adolescents with intellectual disabilities had sedentary behavior time of more than 2 h/d. The sedentary behavior time per day during the whole week among children and adolescents with intellectual disabilities was negatively correlated with the amount of time spent in moderate vigorous physical activity among them ( r =-0.16, P <0.05). Conclusion Excessive sedentary behavior has become a growing public health concern among children and adolescents with intellectual disabilities,which warrants targeted healthy behavior intervention.

Objective To observe the clinical efficacy of decitabine combined with half dose CAG regimen in patients with relapsed/refractory acute myeloid leukemia (AML).Methods Clinical data of 8 patients with relapsed/refractory AML who took the therapeutic regimen with decitabine combined with half dose CAG regimen in the Third People's Hospital of Datong from January 2015 to January 2017 were collected.The clinical efficacy and adverse effects were observed.Results After one course treatment by decitabine combined with half dose CAG regimen,3 patients achieved complete remission,and 2 patients achieved partial remission.The major adverse reactions were myelosuppression and infection,8 patients appeared grade Ⅲ-Ⅳ myelosuppression,5 patients appeared infection,2 patients appeared grade Ⅰ abnormality of liver and no treatment-related death occurred.Conclusion Decitabine combined with half dose CAG regimen is effective for relapsed/refractory AML,and this regimen is worthy of further study.

Objective To investigate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in assessing liver cirrhosis preoperatively in infants with biliary atresia (BA).Methods A total of 64 consecutive infants with BA who underwent ARFI imaging in 3 days before Kasai surgery were recruited.Virtual Touch Quantification mode was used to measure shear wave speed (SWS),All infants with BA underwent liver biopsy during the surgery.The mean SWS of infants with and without liver cirrhosis were compared and analyzed.The diagnostic efficacy of SWS was observed using ROC curves.Results Liver cirrhosis was found in 8 of 64 infants.The mean SWS in infants with cirrhosis was significant-ly higher than that in infants without cirrhosis ([2.51±0.50]m/s vs [1.74±0.31]m/s,t=6.039,P＜0.001).The cutoff value of SWS for predicting liver cirrhosis was 2.16 m/s,the area under ROC curve was 0.930 (P＜0.001),and the diagnostc sensitivity and specificity was 87.50％ and 92.86％,respectively.Conclusion ARFI imaging is helpful to predic tion of liver cirrhosis in infants with BA preoperatively.It may be an effective method for clinical management and prognosis prediction in infants with BA.

Objective To explore the information distribution of PM2.5 Paper in Foreign Language.Methods This article took PM2.5 papers as research object,used GoPubMed as information search and statistical analysis tool to conduct information mining of PM2.5 literature,including subject,time,author,source,distribution and number of publications over time.Results There was steady development of PM2.5 literature published in foreign language from 2004 to 2012,dramatic increase during the year 2013 to 2015.The three top publishing years of PM2.5 literature were 2015,2014 and 2013.Main authors of such literature include Chow J,Watson J,Koutrakis P and so on.Main research countries include United States,China,Canada,etc.Big cities,like Beijing,Shanghai,Boston were main places conducted such PM2.5 research.Related articles mainly published in journals such as J Air Waste Manag Assoc,Environ Sci Technol,Sci Total Environ and so on.Six out of the top ten research journals have higher impact factors than the average level of all journals of SCI in 2014.Main research terminologies include particulate matter,air pollutants,particle size and so on.Conclusions Generally,the PM2.5 literature over the world has a high level academically and China plays a significant role in such research.

Objective To explore the information distribution of PM2.5 periodical paper both in English and Chinese in China.Methods Comprehensive analysis result was made based on the overall output of literature,academic attention trend,literature distribution and growth trend,authority institution and author ranking using high volume database,data mining,clustering analysis and visualization technology.Results There has been a rapid rise in the Chinese PM2.5 periodical paper in recent 5 years,with a sharp rise during the year 2011 to 2013 and the biggest rise in 2012.The periodicals that carry Chinese PM2.5 literature are mainly in the subjects of environment,health,resources.Researching organizations are mainly domestic famous comprehensive universities or research institutions.Core journal lists include those of China science and technology information institute,Peking University,and Chinese academy of science.Research terms mainly include PM2.5 air pollution,haze,particulate matter.Compared to the PM2.5 literature in Chinese,there has been slower development of literature in English in recent 5 years.Research organizations mainly include famous comprehensive universities or research institutions,and most of the literature are embodied in SCI,EI and Medline.Conclusions Some certain achievements have been made towards the PM2.5 research in China and the overall academic level of periodical paper is high,laying solid foundation for having a scientific knowledge of PM2.5 and taking countermeasure for haze.

OBJECTIVETo explore the effect of a Chinese medicine, Xiaoaiping, in combination with cisplatin on the proliferation, invasion and apoptosis in human ovarian cancer HO-8910PM cells in vitro and vivo.

METHODSCCK-8 assay was used to detect the inhibitoty effect of Xiaoaiping alone or in combination with cisplatin on the proliferation of human ovarian cancer HO-8910PM cells. Flow cytometry was used to detect the apoptosis and cell cycle distribution. Transwell migration test was used to assay the effect of drugs on the cell invasive capability. Changes of the tumor volume in nude mice were observed to evaluate the antitumor effects in vivo.

RESULTSCCK-8 assay Xiaoaiping alone or combined with cisplatin could inhibit the proliferation of HO-8910PM cells with a dose-dependent manner. The inhibition rates of Xiaoaiping combined with cisplatin were (53.4±3.0)%, significantly increased than those with single drug (P<0.05). Flow cytometry showed that G0/G1 fraction was increased respectively from (64.2±1.6)% to (74.1±1.6)% and (68.6±1.6)%. The percentages of apoptotic cells were increased from (2.2±1.6)% to (16.1±1.6)%, (35.6±1.6)% after treated with Xiaoaiping, Cisplatin and combination drugs (P<0.05 for all). Transwell chamber with matrigel assay showed that number of cells penetrating through membrane in HO-8910PM cells was (89.2±20.7)/HPF in the drug combination group, significantly less than that in the control group(187.2±24.6)/HPF, Xiaoaiping(141.8±13.7 )/HPF or cisplatin group (155.8±19.4)/HPF (P<0.01 for all). The inhibition rate of drug combination group in the nude mouse transplanted tumors, compared with that of single Xiaoaiping and cisplatin group, was increased significantly (59.0% vs. 23.4% and 34.2%), (P<0.01 for both).

CONCLUSIONThe results of our in vitro and vivo experiments indicate that Xiaoaiping can inhibit cell proliferation, increase G0/G1 arrest, promote apoptosis, inhibit cell migration of human ovarian cancer HO-8910 PM cells, and can synergistically enhance the antitumor activity of cisplatine.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Mice, Nude ; Neoplasm Invasiveness ; Ovarian Neoplasms ; drug therapy ; pathology

In the twenty-first Century,with the rapid development and popularization of the In ternet and E-learning,bending learning is given a new definition,which claims the advantage combination of traditional learning and E-Learning,advocates the teaching mode of teachers' leading role and students' predominant position.Micro-lecture is a newly emerging force on teaching.This study probes into the medical micro-lecture design mode based on the concept of blending Learning,illustrates the stages of teaching preparation,micro-lecture design,micro-lecture application and evalua tion in order to improve higher medical education.

Objective To probe into the status and development trend of ebola,so as to provide reference for further research.Methods This paper took the ebola literature as the object of study,took GoPubMed as the retrieval and statistical tool,and conducted information analysis of the subjects,time,sources,distribution,authors and literature development trends of ebola research.Results The main subjects of ebola literature involved ebola virus and hemorrhagic fever,ebola.There has been a sharp increase on the literature number of ebola in the recent two years,particularly in 2014.The majority of literature came from the United States,and Britain ranked the second.The sources of ebola literature were mainly the SCI journals published in the United States and British.Conclusions GoPubMed can provide a vivid picture of the current situation and development trend of ebola research.Further improvements are needed both in the quality and quantity of ebola research in China.

Objective To investigate the clinical characteristics and efficacy of acute myeloid leukemia (AML) with NPM1 and FLT3 mutations.Methods NPM1 and FLT3 mutations were detected in 67 patients with newly diagnosed AML by PCR-capillary electrophoresis.The relationship was analyzed between the mutations and efficacy.Results The incidence of NPM1 mutation was 10.4％ (7/67) in total AML patients and 26.1％ (6/23) in normal karyotypes AML patients.The incidence of FLT3-ITD mutation was 10.4％ (7/67) in total AML patients and 17.4％ (4/23) in normal karyotypes AML patients.The characteristics of 60 NPM1 wild type patients vs that of 7 NPMl mutation patients was as follow,platelet count (BPC) (54× 109/L vs.27.5 × 109/L,P ＜ 0.01),proportion of AML-M5 (57.1％ vs.27.3％,P ＜ 0.01),incidence of CD34+ (28.6％ vs.63.3％,P＜0.01),normal karyotypes (85.7％ vs.28.3％,P＜0.01),cases with particular fusion gene (0 vs.48.3％,P ＜ 0.01),incidence of FLt3-1TD-mutations positive (28.6％ vs.8.3％,P ＜ 0.01),and the differences were significant (P＜0.01).No statistic difference was found in white blood cell(WBC) counts,percentage of blasts in bone marrow,sex,median age and complete remission rate between the two groups (P ＞0.05).The WBC counts (26.9 × 109/L vs.8.1 × 109/L,P =0.013),percentage of blastsin in bone marrow (90％ vs.76％,P=0.014) in the FLT3-ITD mutationg positive patients were clearly higher than those in the FLT3-ITD negative patients.If not associated with FLT3-ITD mutations,mutant NPM1 appears to identify patients with improved response toward treatment.Conclusion It is necessary to detect NPM1 mutation and FLT3-ITD mutation in newly diagnosed AML patients,especially in patients with normal karyotype,which might help to molecular classification and treatment.