[Chronic hepatitis B virus infection-related osteoporosis].

Clinically, osteoporosis is often observed in combination with different disease states in patients with hepatitis B virus infection, but because of its complex pathogenesis, non-specific early clinical manifestations, and inadequate clinical attention, the patient's prognosis is frequently affected. This review summarizes the pathogenesis, diagnosis, and treatment of chronic hepatitis B virus infection-related osteoporosis in order to raise awareness of the disease.

[Roles of the CXCR1/CXCL8 axis in abnormal proliferation of bile duct epithelial cells in primary biliary cholangitis].

Objective: To investigate the role of the CXC chemokine receptor 1 (CXCR1)/CXC chemokine ligand 8 (CXCL8) axis in the abnormal proliferation of bile duct epithelial cells in primary biliary cholangitis (PBC). Methods: 30 female C57BL/6 mice were randomly divided into the PBC model group (PBC group), reparixin intervention group (Rep group), and blank control group (Con group) in an in vivo experiment. PBC animal models were established after 12 weeks of intraperitoneal injection of 2-octanoic acid coupled to bovine serum albumin (2OA-BSA) combined with polyinosinic acid polycytidylic acid (polyI:C). After successful modelling, reparixin was injected subcutaneously into the Rep group (2.5 mg · kg(-1) · d(-1), 3 weeks). Hematoxylin-eosin staining was used to detect histological changes in the liver. An immunohistochemical method was used to detect the expression of cytokeratin 19 (CK-19). Tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ) and interleukin (IL)-6 mRNA expression were detected by qRT-PCR. Western blot was used to detect nuclear transcription factor-κB p65 (NF-κB p65), extracellularly regulated protein kinase 1/2 (ERK1/2), phosphorylated extracellularly regulated protein kinase 1/2 (p-ERK1/2), Bcl-2-related X protein (Bax), B lymphoma-2 (Bcl-2), and cysteine proteinase-3 (Caspase- 3) expression. Human intrahepatic bile duct epithelial cells were divided into an IL-8 intervention group (IL-8 group), an IL-8+Reparicin intervention group (Rep group), and a blank control group (Con group) in an in vitro experiment. The IL-8 group was cultured with 10 ng/ml human recombinant IL-8 protein, and the Rep group was cultured with 10 ng/ml human recombinant IL-8 protein, followed by 100 nmol/L Reparicin. Cell proliferation was detected by the EdU method. The expression of TNF-α, IFN-γ and IL-6 was detected by an enzyme-linked immunosorbent assay. The expression of CXCR1 mRNA was detected by qRT-PCR. The expression of NF-κB p65, ERK1/2 and p-ERK1/2 was detected by western blot. A one-way ANOVA was used for comparisons between data sets. Results: The results of in vivo experiments revealed that the proliferation of cholangiocytes, the expression of NF-κB and ERK pathway-related proteins, and the expression of inflammatory cytokines were increased in the Con group compared with the PBC group. However, reparixin intervention reversed the aforementioned outcomes (P<0.05). In vitro experiments showed that the proliferation of human intrahepatic cholangiocyte epithelial cells, the expression of CXCR1 mRNA, the expression of NF-κB and ERK pathway-related proteins, and the expression of inflammatory cytokines were increased in the IL-8 group compared with the Con group. Compared with the IL-8 group, the proliferation of human intrahepatic cholangiocyte epithelial cells, NF-κB and ERK pathway-related proteins, and inflammatory indicators were significantly reduced in the Rep group (P < 0.05). Conclusion: The CXCR1/CXCL8 axis can regulate the abnormal proliferation of bile duct epithelial cells in PBC, and its mechanism of action may be related to NF-κB and ERK pathways.

[Precise diagnosis and treatment of hemophagocytic lymphohistiocytosis guided by cytokine patterns].

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening entity which presents as multi-organ dysfunction caused by overactivated T cell and macrophage and overwhelming hyperinflammation. Cytokine storm is the key pathophysiology of HLH. Due to the diversity of the underlying diseases, the difference of disease severity and the non-specific clinical manifestation, the early diagnosis and standardized treatment is a great challenge for clinicians. According to previous clinical studies, serum cytokine measurement is helpful for rapid diagnosis of HLH and the differentiation of HLH from other diseases caused by hypercytokinemia, and it perfoms well to clarify subtypes of HLH, to stratify patients with different risks and to predict the prognosis and outcome. Thus, serum cytokine measurement could be a useful tool for the precise diagnosis and treatment of HLH.

Gout in China, 1990-2017: the Global Burden of Disease Study 2017.

OBJECTIVE: The aim of the study was to estimate the gout burden and risk factors in China from 1990 to 2017. STUDY DESIGN: The Global Burden of Disease (GBD) Study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS: We used the results from the GBD Study 2017 to compare disability-adjusted life years (DALYs), prevalence, incidence, and risk factors of gout in China. The median of the percentage change and 95% uncertainty intervals were determined for the period between 1990 and 2017. RESULTS: The age-standardized DALY rate, prevalence, and incidence increased 6.92%, 6.88%, and 6.16%, respectively, in China from 1990 to 2017. Although the rates of gout both globally and in China were increasing, the range of change for males in China was larger than that of the global level. All risk factors combined accounted for 30.04% of gout DALYs in 2017. The leading risk factors for gout DALYs were high body mass index and impaired kidney function, and the proportion of high body mass index increased significantly from 10.67% to 24.31%, whereas the proportion of impaired kidney function remained basically unchanged. CONCLUSIONS: The age-standardized DALY rate, prevalence, and incidence in China have increased progressively since 1990. Increasing attention on body weight management should be prioritized for controlling the rising prevalence of gout in the young and middle-aged population.

Identification of serum metabolites associated with obesity and traditional risk factors for metabolic disease in Chinese adults.

BACKGROUND AND AIMS: Obesity is a major worldwide health problem and is often associated with many metabolic diseases. Levels of several serum-specific metabolites may be altered in patients with these metabolic diseases. We aimed to investigate the associations of serum metabolite levels with obesity and traditional risk factors for metabolic disease in Chinese individuals. METHODS AND RESULTS: Six-hundred Chinese individuals undergoing annual physical exams were recruited and categorized into overweight/obese and control groups (1:1 ratio). We simultaneously quantified the serum lysophosphatidylcholine (LPC), branched-chain amino acids (BCAA), aromatic amino acids (AAA), 25-hydroxyvitamin D, glutamine (Gln), glutamic acid (Glu), and Gln/Glu ratio levels using our previously established targeted serum metabolomic method. The overweight/obesity group had significantly higher levels of BCAA, AAA, and Glu, as well as lower levels of unsaturated LPC, Gln, and Gln/Glu, than the control group. Correlation analyses revealed significant and positive relationships of saturated LPC, BCAA, AAA, and Glu with blood pressure, glucose, triglycerides, apolipoprotein B, and high-sensitivity C-reactive protein, while unsaturated LPC, Gln, Gln/Glu, and 25-hydroxyvitamin D exhibited an opposite trend. In the multifactor logistic regression model, low unsaturated LPC and Gln/Glu, as well as high BCAA and AAA levels, were found to be independent risk factors for obesity; the odds ratios (95% confidence interval) of the highest quartile compared to the lowest quartile were 0.241 (0.139-0.417), 0.436 (0.252-0.755), 3.944 (2.094-7.430), and 2.357 (1.274-4.361) (P < 0.01), respectively. CONCLUSION: LPC, BCAA, AAA, and Gln/Glu are significantly related to obesity development and risk factors of some metabolic diseases.

Chronic obstructive pulmonary disease deaths, disability-adjusted life years, and risk factors in Hubei province of mid-China, 1990-2015: the Global Burden of Disease Study 2015.

OBJECTIVES: The trends of chronic obstructive pulmonary disease (COPD) mortality and prevalence from 1990 to 2015 in Hubei province of mid-China remain unknown. We used findings from the Global Burden of Disease (GBD) 2015 study to estimate the COPD burden and attributable to risk factors in Hubei province of China from 1990 to 2015. STUDY DESIGN: The GBD study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS: Data were extracted from the GBD 2015 study. Statistical models were used to produce comprehensive results of COPD deaths, prevalence, disability-adjusted life years (DALYs), years of life lost, years lived with a disability, and attributable to risk factors in Hubei. The median of the percent change and 95% uncertainty intervals were determined for the period between 1990 and 2015. RESULTS: In 2015, there were 37,144 deaths from COPD in Hubei, accounting for 10.05% of the total deaths in Hubei. The age-standardized COPD death rate was reduced by 60.28% from 188.67 per 100,000 (in 1990) to 74.94 per 100,000 (in 2015). The age-standardized prevalence decreased from 4.30% (1990) to 2.85% (2015). By 2015, the leading risk factors for all ages COPD DALYs were smoking and ambient particulate matter pollution, accounting for 44.69% and 32.91%, respectively. The proportion of ambient ozone pollution was increasing steadily each year since 1990. CONCLUSION: Hubei has made substantial progress in reducing the mortality due to COPD since 1990, but the absolute number of COPD cases is increasing steadily, given the population growth and aging. The increasing contribution from smoking, ambient particulate matter pollution, and ambient ozone pollution should require growing attention.

10-Hydroxycamptothecin induces apoptosis in human neuroblastoma SMS-KCNR cells through p53, cytochrome c and caspase 3 pathways.

Neuroblastoma (NB), the most common extracranial solid tumor in childhood, remains one of the most challenging types of cancer to treat. Therefore, the search for novel effective drugs for its treatment is essential. The present study used 10-hydroxycamptothecin (HCPT), which is a naturally occurring alkaloid anticancer agent extracted from the Chinese tree, Camptotheca acuminata, and has a strong anticancer activity in vitro and in vivo. HCPT is able to induce apoptosis in cells of various tumor types. However, few studies have been conducted on its efficacy in NB, and its apoptosis-inducing mechanism has not been elucidated. In the present study, the in vitro effects of HCPT on apoptosis in the human NB cell line, SMS-KCNR, and its underlying molecular mechanisms were investigated. Cell proliferation was measured by an MTT assay and apoptosis was measured using DAPI staining and flow cytometric analysis. In addition, western blot analysis was used to evaluate the apoptosis-associated signaling pathways. HCPT was observed to markedly inhibit cell proliferation and induce apoptosis in SMS-KCNR cells at a relatively low concentration (2.5-20 nM). DAPI staining revealed typical apoptotic feature, namely apoptotic body formation. The flow cytometric analysis revealed that the number of apoptotic cells increased from 20.89% (for 2.5 nM) to 97.66% (for 20 nM) following HCPT treatment for 48 h. Western blot analysis revealed that p53, cytoplasmic cytochrome c, cleaved caspase-3 and poly ADP-ribose polymerase (PARP) proteins were significantly upregulated, while the mitochondrial cytochrome c and pro-caspase-3 proteins were downregulated. However, the B-cell lymphoma 2 and Bcl-2-associated X proteins were unaffected. The results indicated that HCPT may inhibit proliferation and induce apoptosis in the SMS-KCNR cells. The possible mechanism of apoptosis induction is the p53-mediated mitochondrial apoptotic signaling pathway, which promotes cytochrome c release and induces apoptosis by activating caspase-3 and PARP. Our study provides experimental evidence for HCPT as a potent therapeutic drug in NB treatment.

Prognostic significance of the Musashi-2 (MSI2) gene in childhood acute lymphoblastic leukemia.

The prognostic value of the Musashi-2 (MSI2) gene has not yet been studied in childhood acute lymphoblastic leukemia (ALL). In our study, MSI2 mRNA levels of 119 childhood patients with newly-diagnosed ALL were examined and analyzed with regard to clinical characteristics and outcomes. ALL patients demonstrated significantly higher MSI2 mRNA levels than healthy controls. In addition, MSI2 mRNA levels were correlated with the disease status and IK6 mutation status. Survival analyses showed that higher MSI2 mRNA levels predicted worse outcomes in patients with childhood ALL. Moreover, in multivariate analyses, MSI2 mRNA overexpression retained its value as an independent risk factor for overall survival (OS), but not for event free survival (EFS). We conclude that high MSI2 mRNA level predicts adverse prognosis and seems to be useful as a novel prognostic factor for patients with childhood ALL.

Effectiveness of bacterial infection-related cytokine profile (BIRCP) determination for monitoring pathogen infections in children with hemopathy in the bone marrow inhibition phase.

Serum cytokine profiles were analyzed before and after infection in children with hemopathy in the bone marrow inhibition phase to explore the utility of cytokine variations for detecting infections. Serum Th1/Th2 cytokine levels, including tumor necrosis factor, interleukin (IL)-2, IL-4, IL-6, IL-10, and interferon, were quantitatively determined by cytometric bead array technology in 480 cases (230 children) of children with hemopathy in the bone marrow inhibition phase with signs of infection, such as fever, and without, to establish baseline and affected levels for comparison with healthy control children. We used the cytokine profile of infected, blood culture-positive children to establish a bacterial infection-related cytokine profile (BIRCP) for predicting infections by pathogens in blood culture-negative children. Overall, 82.9% of children with Gram-negative bacterial infections were accompanied by marked increases of IL-6 and IL-10 levels [>10 times (means ± SD)], whereas only a mild increase of IL-6 levels occurred in Gram-positive bacteria-infected children [>2 times (means ± SD)] and only a mild increase of IFN-γ levels occurred in fungal culture-positive children [>2 times (means ± SD)]. Gram-positive bacterial and fungal infections did not cause a marked increase in IL-6 or IL- 10 levels. The effective rate (86.05%, N = 43) of infectious cases predicted by BIRCP was significantly higher than that obtained using traditional methods for selecting antibiotics based on clinical indications (65.45%, N = 55, P < 0.05). In summary, BIRCP can be used to predict the infections by pathogens in children with hemopathy and to select appropriate antibiotics.

Application of home-based wearable technologies in physical rehabilitation for stroke: A scoping review.

Using wearable technologies in the home setting is an emerging option for self-directed rehabilitation. A comprehensive review of its application as a treatment in home-based stroke rehabilitation is lacking. This review aimed to (1) map the interventions that have used wearable technologies in home-based physical rehabilitation for stroke, and (2) provide a synthesis of the effectiveness of wearable technologies as a treatment choice. Electronic databases of the Cochrane Library, MEDLINE, CINAHL, and Web of Science were systematically searched for work published from their inception to February 2022. This scoping review adopted Arksey and O'Malley's framework in the study procedure. Two independent reviewers screened and selected the studies. Twenty-seven were selected in this review. These studies were summarized descriptively, and the level of evidence was assessed. This review identified that most research focused on improving the hemiparetic upper limb (UL) function and a lack of studies applying wearable technologies in home-based lower limb (LL) rehabilitation. Virtual reality (VR), stimulation-based training, robotic therapy, and activity trackers are the interventions identified that apply wearable technologies. Among the UL interventions, "strong" evidence was found to support stimulation-based training, "moderate" evidence for activity trackers, "limited" evidence for VR, and "inconsistent evidence" for robotic training. Due to the lack of studies, understanding the effects of LL wearable technologies remains "very limited." With newer technologies like soft wearable robotics, research in this area will grow exponentially. Future research can focus on identifying components of LL rehabilitation that can be effectively addressed using wearable technologies.

Radiographic outcomes of lateral sinus floor elevation with and without bone window repositioning: one-year results of a randomized controlled trial.

The objective of this study was to perform a comparative evaluation of the radiographic outcomes of lateral sinus floor elevation with and without bone window repositioning (BLSFE and LSFE, respectively) when applied concomitantly with implant placement. A randomized controlled clinical trial was conducted between February 1, 2016 and May 1, 2017 including 26 individuals with at least one missing tooth. Participants were randomized 1:1 to undergo BLSFE (10 participants, 16 implants) or LSFE (13 participants, 19 implants). Bovine-derived xenograft was used in both groups and the implants were inserted concomitantly. In the BLSFE group, the antrostomy was covered with a repositioned bone window and then with a concentrated growth factors (CGF) membrane. In the LSFE group, the antrostomy was covered with a CGF membrane. Panoramic radiographs were taken before surgery (T0), immediately postoperative (T1), and at 12 months postoperative (6 months after loading) (T2). Marginal bone loss (MBL), apical bone gain, augmented alveolar bone height, and intra-sinus bone augmentation were evaluated on panoramic radiographs at T2. A linear regression analysis with generalized estimating equation models was performed. The implant survival rate was 100% at 1 year after implant surgery. The residual alveolar bone height at T0 was comparable in the BLSFE and LSFE groups (3.58 ± 1.49 mm vs 4.12 ± 1.61, P = 0.32), as was the alveolar bone height at T1 (13.61 ± 1.82 mm vs 12.38 ± 1.82 mm, P = 0.06). At T2, significantly higher alveolar bone height, intra-sinus bone augmentation, and apical bone gain, and lower distal MBL were observed in the BLSFE group when compared to the LSFE group, with adjusting for covariates (ß = 2.44, 95% CI 1.42-3.46, P < 0.0001; ß = 2.38, 95% CI 1.35-3.41, P < 0.0001; ß = 2.33, 95% CI 1.23-3.42, P < 0.0001; and ß = -0.43, 95% CI -0.83 to -0.02, P = 0.038, respectively). No significant difference was observed for mesial MBL or apical bone resorption at T2. Lateral sinus floor elevation with bone window repositioning may result in higher bone augmentation after 1 year than the traditional approach. Further research is needed to elucidate the effect of lateral sinus floor elevation with bone window repositioning.

Simulated global climate change benefits the nutritive value of oat grass.

Numerous data demonstrate that global climate change affects crop yield and quality. However, the effect of climate change on the nutritive value of forage crops remains unclear. Oat grass (Avena sativa L.) was used as a representative forage crop to understand changes in yield and chemical composition. The growth of oat grass under elevated temperature and CO2 conditions was simulated in a 51-day growth experiment inside OTCs. The oat grass was harvested during the heading period and yield, nutrient content, macro- and micro-mineral content and in vitro dry matter digestibility (IVDMD) determined. The fresh and dry yield, mineral P and Fe content and IVDMD of oat grass increased under increased CO2 concentrations (P < 0.05). As temperature increased, dry matter yield and soluble sugar content decreased and the content of Na, Mg, P, S, Ca, Mn, Fe, Cu and Zn increased (P < 0.05), while IVDMD was not significantly affected. Under the interaction of increasing CO2 and temperature, the content of Mg, P, S, Ca, Mn and IVDMD of oat grass increased (P < 0.05); however, there was no significant effect on yield. Climate change may result in oat grass containing more digestible nutrients and minerals for ruminants.

[Associations between different levels of blood pressure and risk of prediabetes].

Objective: To explore sex and rural-urban differences in the associations of different blood pressure levels with the risk of prediabetes. Methods: We used a multi-stage stratified cluster random sampling method to investigate 21 637 residents aged ≥18 years from 10 survey areas in Hubei province in 2020. The data on questionnaire, physical measurements, and laboratory indicators of the participants were collected. The associations of different blood pressure levels with risk of prediabetes by sex and regions were analyzed using multivariate logistic regressions after complex weighting. Results: A total of 16 111 subjects were included. The prevalence (95%CI) of prediabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and IFG complicated with IGT were 25.1% (14.4%-35.9%), 12.7% (3.2%-22.1%), 8.1% (6.3%-9.8%), and 4.4% (2.3%-6.5%), respectively. After multivariate adjustment, the risk of prediabetes, IFG, IGT, and IFG complicated with IGT increased with the increment of blood pressure (both P for trend <0.05). The positive dose-response relationships between blood pressure levels and risk of prediabetes were also significant among male, urban, and rural residents (both P for trend <0.05), and the interactions between sex and blood pressure showed significant associations for risk of prediabetes and IGT (both P for interaction <0.05). Conclusions: Higher blood pressure levels were associated with an increased risk of prediabetes. The association with prediabetes was stronger in males, but no significant difference was found between urban and rural residents. More distinctive and effective prevention and control strategies should be developed for different populations.

A prospective study evaluating spontaneous healing of aetiology, size and type-different groups of traumatic tympanic membrane perforation.

OBJECTIVES: To evaluate the outcome of spontaneous healing of aetiology-, size- and type-different groups of acute traumatic eardrum perforation and to characterise changes in the morphology of the healing eardrum in various conditions. STUDY DESIGN: Prospective clinical study. SETTING: University-affiliated teaching hospital. PARTICIPANTS: A total of 126 patients who visited the Outpatient Department of the Otolaryngology Clinic of Yiwu Central Hospital, Yiwu, China between January 2008 and June 2009 with acute traumatic tympanic membrane perforations. MAIN OUTCOME MEASURES: All participants were allowed to heal spontaneously for 12 months. The clinical outcome including healing rate, healing time, hearing function and air-bone gap recovery as well as morphological changes of the healing tympanic membrane was evaluated on the bases of perforation aetiology, size and type, etc. RESULTS: By perforation size, the overall healing rate at the end of the 12-month follow-up was comparable to each other in the three (small, medium and large) size groups (P > 0.05); however, there were significant perforation size-dependent differences in the average closure time (P < 0.05). For serosanguinous discharge and dry perforations, the healing rate at the end of 12-month follow-up was similar (95%versus 85%, P > 0.05), but the average healing time was different (16 versus 28 days, P < 0.01) and so was the sequence of granulation tissue formation and epithelial migration in the course of perforation healing. The inverted or everted edges as compared with no curled edges did not significantly affect the healing rate (95%versus 82%, P > 0.05) or closure time (24 versus 27 days). Hearing loss differed significantly between perforations of different causes (P < 0.01), but the perforation cause did not affect recovery of the air-bone defect. Pre-existing tympanosclerosis was the most prominent cause of healing failure. CONCLUSION: The clinical outcome of spontaneous healing of acute tympanic membrane perforations is generally associated with perforation size, aetiology and whether dry or with a serosanguenous discharge. The sequence of granulation tissue formation and epithelial migration differs during the healing of traumatic tympanic membrane formation in serosanguinous discharge conditions and dry perforation.

Immersive Learning Design for Technology Education: A Soft Systems Methodology.

Science, technology, engineering and mathematics (STEM) education is a globalized trend of equipping students to facilitate technological and scientific developments. Among STEM education, technology education (TE) plays a significant role in teaching applied knowledge and skills to create and add value to systems and products. In higher education, the learning effectiveness of the TE assisted by the immersive technologies is an active research area to enhance the teaching quality and learning performance. In this study, a taught subject of radio frequency identification (RFID) assisted by using mixed reality technologies in a higher education institution was examined, while the soft systems methodology (SSM) was incorporated to evaluate the changes in learning performance. Under the framework of SSM, stakeholders' perceptions toward immersive learning and RFID education are structured. Thus, a rich picture for teaching activities is established for subject control, monitoring, and evaluation. Subsequently, the design of TE does not only satisfy the students' needs but also requirements from teachers, industries, and market trends. Finally, it is found that SSM is an effective approach in designing courses regarding hands-on technologies, and the use of immersive technologies improves the learning performance for acquiring fundamental knowledge and application know-how.

Survey data on the impact of COVID-19 on parental engagement across 23 countries.

This data article describes the dataset of the International COVID-19 Impact on Parental Engagement Study (ICIPES). ICIPES is a collaborative effort of more than 20 institutions to investigate the ways in which, parents and caregivers built capacity engaged with children's learning during the period of social distancing arising from global COVID-19 pandemic. A series of data were collected using an online survey conducted in 23 countries and had a total sample of 4,658 parents/caregivers. The description of the data contained in this article is divided into two main parts. The first part is a descriptive analysis of all the items included in the survey and was performed using tables and figures. The second part refers to the construction of scales. Three scales were constructed and included in the dataset: 'parental acceptance and confidence in the use of technology', 'parental engagement in children's learning' and 'socioeconomic status'. The scales were created using Confirmatory Factor Analysis (CFA) and Multi-Group Confirmatory Analysis (MG-CFA) and were adopted to evaluate their cross-cultural comparability (i.e., measurement invariance) across countries and within sub-groups. This dataset will be relevant for researchers in different fields, particularly for those interested in international comparative education.

A study of semi-rigid support on ankle supination sprain kinematics.

Ankle sprain injury is very common in sports and the use of ankle support is crucial. This research investigated the effect of an ankle brace in reducing the ankle angular displacement and angular velocity during sudden supination. In the experiment, 11 healthy males were tested. The bracing condition, semi-rigid ankle braces were investigated. The angular displacement and angular velocity of the ankle were computed. The motion-capture system was adopted to capture the three-dimensional coordinates of the reflective markers. The coordinates of the reflective markers were used to compute the ankle kinematics during simulated ankle supination. A mechanical supination platform was used to simulate the sprain motions. Experimental results showed that the semi-rigid brace tested significantly reduced the ankle angular displacement and angular velocity compared with control conditions during sudden supination. In conclusion, the semi-rigid-type brace can provide significant restriction to reduce the magnitudes of the angular displacement and angular velocity of the ankle during sudden supination sprain. The semi-rigid-type brace is suggested as the prophylactic bracing for the ankle.

[Long-term outcome of childhood T-cell acute lymphoblastic leukemia treated with modified national protocol of childhood leukemia in China-acute lymphoblastic leukemia 2008].

Objective: To analyse the long-term efficacy in childhood T-cell acute lymphoblastic leukemia (T-ALL) cases enrolled in the national protocol of childhood leukemia in China-acute lymphoblastic leukemia (NPCLC-ALL) 2008. Methods: Clinical data of 96 patients diagnosed as T-ALL and treated with NPCLC-ALL2008 protocol between January 2009 and December 2017 in the Department of Hematology-Oncology, the Children's Hospital, Zhejiang University School of Medicine were analyzed retrospectively. Predictive value of minimal residual disease (MRD) monitored by flow cytometry was analyzed. Kaplan-Meier method was used for long-term survival analysis. Results: A total of 96 evaluable patients with newly diagnosed T-ALL were analysed, including 72 males and 24 females. The age was 9.5 (ranged from 1.0 to 16.0) years. The follow-up time was 5.7 (ranged from 1.0 to 9.7) years. Among 96 patients, 92 (96%) achieved complete remission. The 5-year event free survival (EFS) and overall survival (OS) rates were (61±6) % and (70±5) %, respectively. Relapse occurred in 18 cases and the 5-year cumulative incidence of relapse was (27±6) %. Twenty-four patients died. The 5-year OS rates of patients with MRD>5% on day 15 of induction therapy was significantly worse than those with MRD≤5% ((60±12) % vs. (72±6) %, χ(2)=3.904, P=0.048) . The 5-year EFS and OS rates were obviously lower in patients with MRD>10% before the consolidation therapy ((50±35) %). The 5-year OS rates of patients with relapsed disease was significantly worse than those without ((26±13) % vs. (81±5) %, χ(2)=18.411, P<0.01). The earlier the relapse, the worse the prognosis. The 5-year OS rates for patients relapsed within 6 months, within 3 years and more than 3 years, were (25±22) %, (30±14) % and (50±35) % respectively (χ(2)=13.207, P<0.01). Conclusions: NPCLC-ALL2008 protocol is effective for childhood T-ALL. The MRD guided accurate risk stratification and individualized treatment can reduce the relapse and improve the survival rate of pediatric T-ALL.

[Predictive value of cytokines and procalcitonin on infection in children with hematological malignancies].

Objective: To explore the value of cytokines and procalcitonin (PCT) in predicting the potential pathogen and the severity of infection in children with hematological malignancies. Methods: This was a prospective cohort study. A total of 1 543 children (3 912 episodes) with hematological malignancies admitted to the Department of Hematology/Oncology in Children's Hospital of Zhejiang University School of Medicine from November 2010 to June 2018 were prospectively enrolled in this study. According to the pathogen, the patients were divided into sepsis group with positive blood culture (380 patients/608 episodes), sepsis group with negative blood culture (539/1 484), non-septic infection group (549/1 709), viral infection group (18/21) and fungal infection group (57/90). The patients were also divided into two groups in either shock group (171/187) or non-shock group (1 372/3 725). Meanwhile, 89 children (112 episodes) with matched hematological malignancies without fever were enrolled as the control group. The levels of PCT and cytokines were measured for detecting the potential relationship between these markers and infection severity. Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between groups. The Receiver Operator Characteristic curve analysis was used to explore the predictive value. Results: (1) There were significantly higher levels of interleukin (IL) 6 (H=210.002, P<0.01), IL-10 (H=223.045, P<0.01), and PCT (H=76.799, P<0.01) in the infection group, with area under curre (AUC) of 0.67 (95%CI 0.64-0.69), 0.69 (95%CI 0.66-0.71) and 0.59 (95%CI 0.56-0.61), respectively. (2) Among the patients in the shock group, IL-6 (Z=11.460, P<0.01), IL-10 (Z=14.242, P<0.01) and PCT (Z=10.813, P<0.01) were significantly higher than those in the non-shock group, with the AUC of 0.75 (95%CI 0.70-0.79), 0.81 (95%CI 0.77-0.84) and 0.73 (95%CI 0.69-0.77), respectively. (3) In patients with septic shock, the incidence of Gram negative bacteria (GNB) infection (60 episodes) was significantly higher than Gram positive bacteria (GPB) infection (22 episodes) (χ(2)=29.665, P<0.01). The AUC of IL-6, IL-10 and PCT for predicting GNB infection were 0.75 (95%CI 0.72-0.78), 0.82 (95%CI 0.79-0.85) and 0.67 (95%CI 0.63-0.70), respectively. (4) The predictive power of IL-6, IL-10 and PCT combination (AUC=0.994) was superior to IL-10 alone (AUC=0.810) in predicting septic shock (Z=10.211, P<0.01). Conclusions: IL-6 and IL-10 are better predictors of GNB infection than PCT in hematology-oncology children. Furthermore, the combination of these two cytokines and PCT is more valuable in predicting the severity of infection.