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Chun-Feng Huang,1,2 Po-Jung Pan,3 Yi-Hung Chiang,4 Shung-Haur Yang5 1Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan (R.O.C); 2Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan (R.O.C); 3Department of Physical Medicine and Rehabilitation, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan (R.O.C); 4Department of Orthopedics, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan (R.O.C); 5Department of Surgery, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan (R.O.C)Correspondence: Chun-Feng HuangDepartment of Family Medicine, National Yang Ming Chiao Tung University Hospital, No. 152, Xinmin Road, Yilan, Yilan County, 26042, Taiwan (R.O.C)Tel +886-3-932-5192Fax +886-3-9372119Email cfhuang.ymuh@gmail.comPurpose: In older adults, the one-year mortality rate after experiencing a hip fracture ranges between 8% and 36%. The purpose of this study was to look at the efficacy of rehabilitation-based multidisciplinary care for older individuals who had hip fractures.Patients and Methods: The study included 185 people (aged 65 and over) with a history of hip fracture surgery between February 2014 and March 2017. A survey was conducted one month and six months following the operation to assess the recovery of 93 individuals who were part of a rehabilitation-based multidisciplinary care program and 92 patients who were getting standard therapy with surgery and unsupervised physical therapy.Results: Physical activity, gait, balance evaluation, and depression scale ratings all had statistical significance (P < 0.05) after participants received rehabilitation-based care services from multidisciplinary medical professionals. Furthermore, the refracture and one-year mortality rates in this rehabilitation-based multidisciplinary care model were lower than in the groups getting standard therapy.Conclusion: The research indicates the efficacy of a multidisciplinary rehabilitation strategy provided by a collaborative medical team to older individuals with hip fractures.Keywords: hip fracture, multidisciplinary care, osteoporosis, rehabilitation

Shih-Hsing Yang,1 Mei-Chen Yang,2,3 Yao-Kuang Wu,2,3 Chih-Wei Wu,2,3 Po-Chun Hsieh,4 Chan-Yen Kuo,5 I-Shiang Tzeng,5 Chou-Chin Lan2,3 1Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City, Taiwan; 2Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; 3School of Medicine, Tzu-Chi University, Hualien, Taiwan; 4Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan; 5Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, TaiwanCorrespondence: Chou-Chin LanDivision of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian City, New Taipei City, 23142, TaiwanTel +886-2-6628-9779 Ext. 2259Fax +886-2-6628-9009Email bluescopy@yahoo.com.twIntroduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease with deteriorating cardiopulmonary function that decreases the health-related quality of life (HRQL) and exercise capacity. Patients with COPD often have cardiovascular and muscular problems that hinder oxygen uptake by peripheral tissues, resulting in poor oxygen consumption efficiency. It is important to develop new physiological parameters to evaluate oxygen consumption efficiency during activities and to evaluate its association with exercise capacity and HRQL. Work efficiency (WE) measures oxygen consumption efficiency during exercise. We hypothesize that patients with poor WE should have exercise intolerance and poor HRQL. Therefore, we aimed to evaluate the association between WE and exercise capacity, HRQL and other cardiopulmonary parameters.Patients and Methods: Seventy-eight patients with COPD were evaluated with spirometry, cardiopulmonary exercise testing, and assessment of dyspnea score and HRQL (using the St. George’s Respiratory Questionnaire [SGRQ]). Cardiopulmonary exercise testing was performed using a cycle ergometer with an incremental protocol and exhaled breath analysis to assess oxygen consumption. WE was defined as the relationship between oxygen consumption and workload.Results: There were 31 patients with normal WE (group I) and 47 patients (group II) with poor WE. Patients with poor WE had lower exercise capacity (maximal oxygen consumption, group I vs II as 1050± 53 vs 845 ± 34 mL/min, p=0.0011), poorer HRQL (SGRQ score 41.1± 3.0 vs 55± 2.2, p=0.0002), higher exertional dyspnea score (5.1± 0.2 vs 6.1± 0.2, p= 0.0034) and early anaerobic metabolism during exercise (anaerobic threshold, 672± 27 vs 583 ± 18 mL/min, p=0.0052).Conclusion: WE is associated with exercise capacity and HRQL. Here, patients with poor WE also had exercise intolerance, poorer HRQL, and more exertional dyspnea.Keywords: chronic obstructive pulmonary disease, exercise physiology, work efficiency

Zhi-Hui Gu, Tian Qiu, Shi-Han Yang, Fang-Qiong Tian, Hui Wu Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Hui WuDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang 110122, People’s Republic of ChinaEmail hwu@cmu.edu.cnPurpose: We aim to test whether resilience mediates the association of fear of progression (FoP) with quality of life (QoL) among ovarian cancer patients in China.Methods: We collected 230 questionnaires from the First Affiliated Hospital of China Medical University in Liaoning Province, and 209 completed the questionnaire survey. The survey instrument consisted of four questionnaires: a sociodemographic and clinical characteristics questionnaire, the Functional Assessment of Cancer Therapy general instrument, the Fear of Progression Questionnaire-Short Form and the Connor-Davidson Resilience Scale. Hierarchical regression analysis was used to examine the relationship among FoP, resilience, and QoL, including physical well-being, social well-being, emotional well-being, and functional well-being. We used asymptotic and resampling strategies to examine the indirect effect of resilience.Results: FoP was negatively associated with resilience (r=− 0.543, P< 0.01) and QoL (physical well-being: r=− 0.537, P< 0.01; social well-being: r=− 0.426, P< 0.01; emotional well-being: r=− 0.487, P< 0.01; functional well-being: r=− 0.529, P< 0.01). Resilience was positively related with QoL (physical well-being: r=0.449, P< 0.01; social well-being: r=0.548, P< 0.01; emotional well-being: r=0.430, P< 0.01; functional well-being: r=0.655, P< 0.01). Resilience partly mediated the association between FoP and physical well-being (a×b=− 0.05, BCa 95% CI: − 0.09, − 0.02), social well-being (a×b=− 0.21, BCa 95% CI: − 0.29, − 0.14), emotional well-being (a×b=− 0.05, BCa 95% CI: − 0.08, − 0.02), and functional well-being (a×b=− 0.24, BCa 95% CI: − 0.32, − 0.17). The proportion of the mediating effect accounted for by resilience were 22.57%, 57.22%, 26.02%, 53.42% for physical well-being, social well-being, emotional well-being and functional well-being, respectively.Conclusion: The study showed that resilience could mediate the association between fear of progression and quality of life. It suggests that resilience might provide a potential target for intervention in quality of life with ovarian cancer.Keywords: mediating role, fear of progression, quality of life, resilience, ovarian cancer patients

Zhi-Hui Gu, Tian Qiu, Fang-Qiong Tian, Shi-Han Yang, Hui Wu Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110000, People’s Republic of ChinaCorrespondence: Hui Wu Email hwu@cmu.edu.cnObjective: The objective of this study was to explore the association between perceived organizational support (POS) and depressive symptoms, and to further explore whether self-efficacy can act as a moderator between POS and depressive symptoms among Chinese petroleum workers.Methods: There was a cross-sectional study conducted at a petrochemical enterprise in Liaoning Province, China, from July to August 2018. A series of questionnaires were accomplished by 1836 petroleum workers, including the Center for Epidemiologic Studies Depression Scale (CES-D), the Survey of Perceived Organizational Support (SPOS), and the General Self-Efficacy Scale (GSES). Hierarchical regression analysis was used to examine the relationship of SPOS score, GSES score, and SPOS score×GSES score interaction with CES-D score. A simple slope analysis will be carried out if the interaction has statistical significance.Results: Hierarchical regression analysis showed that SPOS score (β=− 0.538, P< 0.01) and GSES score (β=− 0.313, P< 0.01) played a main influence on CES-D score. The SPOS score×GSES score interaction term significantly explained an extra 9.7% of the variance (F=253.932, adjusted R2=0.582, ΔR2=0.097, P< 0.01). The interaction term was positively correlated with CES-D score (β=0.334, P< 0.01). The relationship between SPOS score and CES-D score gradually decreased in the low (1 SD below the mean, β=− 0.589, P< 0.01), mean (β=− 0.338, P< 0.01), and high (1 SD above the mean, β=− 0.087, P< 0.01) groups of GSES score.Conclusion: This study showed that POS and self-efficacy played a main influence on depressive symptoms, and the interaction term was positively correlated with depressive symptoms. Self-efficacy could attenuate the association between POS and depressive symptoms. It suggests that appropriate POS and self-efficacy enhancement measures ought to be supplied to relieve depressive symptoms.Keywords: moderating role, depressive symptoms, perceived organizational support, self-efficacy, petroleum workers

Xiao-Ming Hou,1,2 Zulqarnain Baloch,3,4 Zhan-Hong Zheng,3,4 Wen-Hui Zhang,1,2 Ying Feng,5 Duan-Duan Li,3,4 Xin-An Wu,2,6 Shi-Hua Yang3,41Department of Oncology, The First Hospital of Lanzhou University, Lanzhou 730000, People’s Republic of China; 2Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, People’s Republic of China; 3College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, People’s Republic of China; 4Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou 510642, People’s Republic of China; 5Department of Pathology, The First Hospital of Lanzhou University, Lanzhou 730000, People’s Republic of China; 6Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou 730000, People’s Republic of ChinaPurpose: The aim of the present study was to explore the role of CHPF in non-small-cell lung cancer (NSCLC) and to develop an shRNA vector-based therapy to repress the expression of CHPF gene in NSCLC cell lines.Methods: In this study, we used immunohistochemical staining to verify the expression of CHPF in NSCLC tissue. Then, we determined the expression of CHPF gene in different NSCLC cell lines with RT-PCR and Western blotting. Specific CHPF shRNA was used to knockdown the expression of CHPF. Celigo image cytometry, cell cycle analysis, and flow cytometry assay were performed.Results: The results showed that expression level of CHPF was higher in NSCLC tissues than normal lung tissues. Further, we established that CHPF expression knockdown in NSCLC cells could substantially restrain the cell proliferation, apoptosis, and cell cycle in vitro.Conclusion: On the basis of these results, we concluded that CHPF expression has an important role in the progression of human NSCLC cells. Therefore, its interference could possibly be used as a potential therapeutic target against NSCLC.Keywords: NSCLC, CHPF, progression, knockdown

Objective: our study aimed at retrospectively assessing the abnormal prenatal ultrasound findings of chromosome 4p deletion syndrome. Methods: 21 cases with abnormal sonographic signs revealed 4p deletion by Chromosome Microarray (CMA) in this retrospective analysis. Clinical information and molecular basis of this cohort were compared with those from other two groups in China, the critical region related to special ultrasound findings was mapped with the smallest regions of overlap. Results: This is the largest prenatal series to evaluate the prenatal ultrasound features of 4p deletion syndrome detected by CMA. Firstly we refined the relationship between the genomic coordinates with IUGR in chromosome 4p terminal deletion syndrome. Additional chromosomal abnormalities was identified in 12 cases. Intrauterine embryonic arrest was diagnosed at first trimester for 9 cases. The most consistent ultrasound indicator was IUGR (95.5%), and the smallest region response for IUGR correspond to a 2.05Mb at 4p16.3-pter (chr4: 68,345-2,121,057, hg19). Increased Nuchal Translucency (NT) could be a risk factor for predicting WHS at first-trimester pregnancy with the rate of 16.6% from our data. A 3.6Mb microdeletion located at 4p16.3-pter (chr4: 68,345-3,753,422, hg19) might be the candidate region associated with increased NT. Conclusion: We identified IUGR as the most common feature in prenatal 4p terminal deletion and Wolf-Hirschhorn syndrome. The existence of additional CNVs may contribution to possible explanations for the clinical heterogeneity of this syndrome. Prenatal findings of IUGR, increased NT or early spontaneous abortion should warrant the diagnosis of 4p terminal deletion WHS.

Xinxin Yan,1,2 Wen Yang,3 Zengwu Shao,1 Shuhua Yang,1 Xianzhe Liu1 1Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 2Department of Orthopaedic Surgery, Wuhan Third Hospital, 3Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China Abstract: Carbon nanomaterials are becoming increasingly significant in biomedical fields since they exhibit exceptional physicochemical and biocompatible properties. Today, the stem cells offer potentially new therapeutic approaches in tissue engineering and regenerative medicine. However, the induction of differentiation into specific lineages remains challenging, which provoked us to explore the biomedical applications of carbon nanomaterials in stem cells. In this study, we investigated the interactions between graphene/single-walled carbon nanotube (G/SWCNT) hybrids and rat mesenchymal stem cells (rMSCs) and focused on the proliferation and differentiation of rMSCs treated with G/SWCNT hybrids. Cell viability and morphology were evaluated using cell counting kit-8 assay and immunofluorescence staining, respectively. Osteogenic differentiation evaluated by alkaline phosphatase activity of MSCs proved to be higher after treatment with G/SWCNT hybrids, and the mineralized matrix nodule formation was also enhanced. In addition, the expression levels of osteogenic-associated genes were upregulated, while the adipocyte-specific markers were downregulated. Consistent with these results, we illustrated that the effect of G/SWCNT hybrids on the process of osteogenic differentiation of rMSCs can be modulated by activating the p38 signaling pathway and inhibiting the extracellular signal-regulated kinase 1/2 pathway. Nevertheless, our study suggests that carbon nanomaterials offer a promising platform for regenerative medicine in the near future. Keywords: carbon-based nanomaterials, 3D nanostructure, stem cell therapy, bone formation

Yang-Yang He,1,2,* Yu Yan,1,3,* Hui-Fang Zhang,1,3 Yi-Huang Lin,3 Yu-Cai Chen,1,3 YiYan,4 Ping Wu,1,3 Jian-Song Fang,5 Shu-Hui Yang,2 Guan-HuaDu1,3 1Beijing Key Laboratory of Drug Target Identification and Drug Screening, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2StateKey Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 3State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of MateriaMedica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 4Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 5Institute of Clinical Pharmacology, Guangzhou University of Traditional Chinese Medicine, Guangzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Systemic lupus erythematosus (SLE), with a high incidence rate and insufficient therapy worldwide, is a complex disease involving multiple organs characterized primarily by inflammation due to deposition of immunocomplexes formed by production of autoantibodies. The mechanism of SLE remains unclear, and the disease still cannot be cured. We used pristane to induce SLE in female BALB/c mice. Methyl salicylate 2-O-β-D-lactoside (MSL; 200, 400, and 800 mg/kg) was orally administered 45 days after pristane injection for 4.5 months. The results showed that MSL antagonized the increasing levels of multiple types of antibodies and cytokines in lupus mice. MSL was found to suppress joint swelling and have potent inhibitory effect on arthritis-like symptoms. MSL also significantly decreased the spleen index and expression of inflammatory markers in the lupus mice. MSL protected the kidneys of lupus mice from injury through inhibiting the expression of inflammatory cytokines and reducing the IgG and C3 immunocomplex deposits. Further Western blot assays revealed that the downregulation of the intracellular inflammatory signals of NFκB and JAK/STAT3 might be the potential molecular mechanisms of the pharmacological activity of MSL against SLE in vivo. These findings may demonstrate that MSL has the potential to be a useful and highly effective treatment for SLE. Keywords: methyl salicylate 2-O-β-D-lactoside, systemic lupus erythematosus, inflammatory response, lupus nephritis, signal transduction&nbsp

Tzu-Ying Yu,1 Kuan-Lin Chen,2,3 Willy Chou,4,5 Shu-Han Yang,4 Sheng-Chun Kung,4 Ya-Chen Lee,2 Li-Chen Tung4,6,7 1Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung, 2Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 3Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 4Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, 5Department of Recreation and Health Care Management, Cha Nan University of Pharmacy and Science, Tainan, 6School of Medicine, Kaohsiung Medical University, Kaohsiung, 7School of Medicine, Chung Shan Medical University, Taichung, Taiwan Purpose: This study aimed to establish 1) whether a group difference exists in the motor competence of preschool children at risk for developmental delays with intelligence quotient discrepancy (IQD; refers to difference between verbal intelligence quotient [VIQ] and performance intelligence quotient [PIQ]) and 2) whether an association exists between IQD and motor competence.Methods: Children’s motor competence and IQD were determined with the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers and Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition. A total of 291 children were included in three groups: NON-IQD (n=213; IQD within 1 standard deviation [SD]), VIQ>PIQ (n=39; VIQ>PIQ greater than 1 SD), and PIQ>VIQ (n=39; PIQ>VIQ greater than 1 SD).Results: The results of one-way analysis of variance indicated significant differences among the subgroups for the “Gross and fine motor” subdomains of the Comprehensive Developmental Inventory for Infants and Toddlers, especially on the subtests of “body-movement coordination” (F=3.87, PPIQ group than in the NON and PIQ>VIQ groups. Significant negative correlations between IQD and most of the motor subtests (r=0.31–0.46, PPIQ group.Conclusion: This study demonstrates that 1) IQD indicates the level of motor competence in preschoolers at risk for developmental delays and 2) IQD is negatively associated with motor competence in preschoolers with significant VIQ>PIQ discrepancy. The first finding was that preschoolers with VIQ>PIQ discrepancy greater than 1 SD performed significantly worse on motor competence than did preschoolers without significant IQD and preschoolers with PIQ>VIQ discrepancy greater than 1 SD. However, preschoolers with significant PIQ>VIQ discrepancy performed better on motor competence than did preschoolers without significant IQD, though the difference was not statistically significant. The second finding was that preschoolers with larger VIQ>PIQ discrepancy had worse motor competence in visual-motor integration and body-movement coordination. Professionals should pay attention to the motor development of children with VIQ>PIQ discrepancy and evaluate children’s IQD along with their motor competence. Keywords: IQ discrepancy, motor competence, child

Shuai Han,* Shaohua Yang,* Zhai Cai, Dongyue Pan, Zhou Li, Zonghai Huang, Pusheng Zhang, Huijuan Zhu, Lijun Lei, Weiwei Wang Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China *These authors contributed equally tothis study Background: The Warburg effect refers to glycolytic production of adenosine triphosphate under aerobic conditions, and is a universal property of most cancer cells. Chronic inflammation is a key factor promoting the Warburg effect. This study aimed to determine whether rosmarinic acid (RA) has an anti-Warburg effect in gastric carcinoma in vitro and in vivo. The mechanism for the anti-Warburg effect was also investigated.Methods: An MTT assay was used to examine MKN45 cell growth in vitro. An enzyme-linked immunosorbent assay was used to detect proinflammatory cytokines. Real-time polymerase chain reaction was used to evaluate levels of microRNA expression in cells. Protein expression was determined by Western blotting assay. Mouse xenograft models were established using MKN45 cells to assess the anti-Warburg effect in gastric carcinoma in vivo.Results: RA suppressed glucose uptake and lactate production. It also inhibited expression of transcription factor hypoxia-inducible factor-1α, which affects the glycolytic pathway. Inflammation promoted the Warburg effect in cancer cells. As expected, RA inhibited proinflammatory cytokines and microRNAs related to inflammation, suggesting that RA may suppress the Warburg effect via an inflammatory pathway, such as that involving interleukin (IL)-6/signal transducer and activator of transcription-3 (STAT3). miR-155 was found to be an important mediator in the relationship between inflammation and tumorigenesis. We further showed that miR-155 was the target gene regulating the Warburg effect via inactivation of the IL-6/STAT3 pathway. Moreover, we found that RA suppressed the Warburg effect in vivo.Conclusion: RA might potentially be a therapeutic agent for suppressing the Warburg effect in gastric carcinoma. Keywords: rosmarinic acid, miR-155, inflammation, Warburg effect, MKN45