Fall is one of major causes of disability, reduced mobility, shortness of life span and increased medical costs in the elderly.There are multiple risk factors for falls in the elderly, but they can be preventable and controlled.This article reviews the evidences regarding the clinical effectiveness, practicalness and security of these fall risk assessment methods and measures of interventions by evidence-based medicine in the elderly and analyzes their research directions.

Objective A study was performed to better define the teaching outcome of computers in teaching medical imaging. Methods 150 4rd-year students were randomly assigned to four groups and experimental group exposed to 20 radiology cases as well as to a voluntary weekly radiology lecture. Group A used computer-based cases with interactive elements; group B used computer-based cases without interactive elements; group C used paper-based cases with interactive elements; and group D was not exposed to the cases and served as a control group. Results On a multiple-choice question test,groups A,B,and C showed significant improvemen(t+10.6%,+15.7%,+13.5%,respectively),whereas group D did not(+2.7%). On an image interpretation test,group A and group B showed the most improvement (+15.8%,P

OBJECTIVE:To observe the effect of Xuezhikang on serum MCP-1 and endothelial function of brachial artery in patients with chronic heart failure but with normal cholesterol level. METHODS:Patients with chronic heart failure (NYHAⅡ-Ⅳ) were randomly allocated into two groups(n=24 each). Both groups received routine treatment in accordance with the guide of CHF treatment,additionally,the treatment group received Xuezhikang 0.6 g bid for 8 weeks. Serum levels of MCP-1 before and after treatment were measured by ELISA and endothelial function of brachial artery was detected by ultrasonography. RESULTS:In Xuezhikang-treated group compared with the control group,serum level of MCP-1 decreased significantly(P

Objective To investigate the prevalence of osteoporosis,osteopenia,fall and brittle fracture and their associated factors in men aged 80 years and over.Methods In a prospective study,184 study subjects with good self-care ability aged 80 years and over were enrolled.The questionnaire included living habits,falls,comorbidities,related symptoms and medicines.The bone mineral density,hand-grip strength,gait speed,timed up and go test(TUG),chair rising test(CRT),bone turnover markers and related hormones were measured.Binary Logistic regression model was used to analyze associated factors for osteoporosis,osteopenia,fall and brittle fracture.Results The prevalence of osteoporosis (OP)and osteopenia(OPA) were 12.5 ％ (23/184) and 45.1％ (83/184) respectively in this study.The height,weight and body mass index were lower,and serum levels of procollagen type 1 N terminal propeptide(P1NP)and C-telopeptides of type 1 collagen(s-CTx)were higher in osteoporosis group than in normal bone mass(NBM) group(P＜0.05,P＜0.01).The estradiol levels were lower in OP and OPA group than in NBM group(P＜ 0.05).The risk factors for OP and OPA included smoking(OR =3.607,P＜0.05),decreased body weight (OR=0.823,P ＜ 0.05) and elevated S-CTx level (OR =12.427,P ＜ 0.01).55.4％ (102/184) of study subjects had fall history after 80-year old.The prevalence of fragile fracture was 17.4％ (4/23),18.1 ％ (15/ 83)and 3.8％(3/78)in OP,OPA and NBM groups respectively,with total prevalence of 12.0％ (22/184).The risk factors for fragile fracture were a decreased total hip BMD(OR 0.017,P＜0.05)and fall history after 80-year-old(OR 13.126,P ＜ 0.05).Conclusions Based on associated factors of osteoporosis,osteopenia,falls and fragile fracture in male aged 80 years and over,the primary and secondary prevention of osteoporosis may need a comprehensive geriatric intervention including lifestyle adjustment,fall prevention and pharmacologic treatments.

Objective To explore the effect of transforming growth factor β1 (TGF-β1) on epithelial-mesenchymal transition in rat peritoneal mesothelial cells(RPMCs) and its mechanism.Methods Primary peritoneal mesothelial cells of SP rats were cultured in vitro. After synchronization for 24 h, RPMCs were randomly divided into 2 groups: Group A (control), Group B (TGF-β1, 10 μg/L). RPMCs were stimulated by 10 μg/L TGF-β1 for different time. The mRNA and protein expression levels of E-cadherin, α-smooth muscle actin (α-SMA) and collagenⅠwere measured by RT-PCR and Western blot, respectively. The protein expression level of total RhoA was measured by Western blot. Active RhoA was extracted by Plasma Membrane Protein Extraction Kit, and assessed by Western blot. Results TGF-β1 down-regulated mRNA and protein expression of E-cadherin in RPMCs, and upregulated mRNA and protein expression of α-SMA and CollagenⅠ. TGF-β1 stimulation elicited a robust increase in RhoA activity in a time-dependent manner. RhoA activity peaked at 1 h.Conclusion RPMCs can be transdifferentiated into myofibroblast under the effect of TGF-(β1,)and the mechanism may be related to the activation of RhoA associated signal pathway.

Objective:To investigate the existence of side population cells with the potency of stem cells in human gallbladder carcinoma cell line GBC-SD and the differences in ABCG2,Oct-4 and CD34 expression among SP cells,non-SP cells and GBC-SD cells.Methods:SP and non-SP cells were sorted from GBC-SD cells by fluorescence-activated cell sorting(FACS).The expression of ABCG2,Oct-4 and CD34 in SP cells,non-SP cells,and GBC-SD cells was detected by reverse transcription-polymerase chain reaction(RT-PCR),Western blot,flow cytometry(FCM)and immunofluorescence chemistry.Results:SP cells with stem cell potency were isolated from GBC-SD cells with a proportion of(0.64±0.08)%.The metastatic ability of SP cells was obviously higher than that of non-SP cells and GBC-SD cells(P<0.05).The expression of ABCG2 was significantly higher in SP cells than in non-SP cells and GBC-SD cells[(89.56±3.86)%vs.(1.32±0.49)%and(12.37±1.61)%,P=0.001].The expression of Oct-4 in these cells was(94.87±1.40)%,(88.16±2.34)%and(90.17±1.61)%,respectively(P>0.05).CD34 was neady absent in these cells on protein level[(1.78±0.51)%vs.(0.63±0.21)%and(0.96±0.381)%,P>0.05)],but it was highly expressed in non-SP cells and GBC-SD cells and absent in SP cells off mRNA leve;.Conclusion:SP calls which hava the potency of stem cells,exist in human gallbladder carcinoma GBC-SD cell line and have the phenotype of ABCG2+Oct-4+CD34-.

Objective To review the epidemiologic features of norovirus infection outbreaks in Zhejiang province during 2004-2014.Methods Epidemiological data of norovirus infection outbreaks in Zhejiang province from January 2004 to February 2014 were collected from the Emergency Public Reporting System in Zhejiang Provincial CDC.The distribution of time,area,population,route of transmission and genotype of norovirus were analyzed.Results There were 16 outbreaks of norovirus infections with 2 037 cases during 2004-2014 in Zhejiang province.Eleven outbreaks occurred during February and April,and 13 outbreaks occurred in schools.The outbreaks in schools mainly involved students aged 15-20 years,while other outbreaks took place mainly in the young and middle-aged population.The sex ratio of male to female was 1.05 ∶ 1.Among 16 outbreaks,10 were induced by norovirus G Ⅱ infections,3 were induced by norovirus G Ⅰ infections and 3 were induced by norovirus G Ⅰ and G Ⅱ infections.Fourteen outbreaks were caused by water pollution.Conclusion Outbreak of norovirus infection usually occurs in schools during winter and spring in Zhejiang province,and the epidemic of disease is mainly associated with polluted water.

Accidents, Occupational ; prevention & control ; Emergency Medical Services ; organization & administration ; Humans ; Occupational Exposure ; prevention & control ; Occupational Health ; Poisoning ; prevention & control ; Risk Assessment

Adult ; Arsenic Poisoning ; etiology ; Female ; Humans ; Male ; Middle Aged ; Organotin Compounds ; poisoning ; Water Pollution ; Young Adult

AIM To observe the effects of Wuwei Wentong Chubi Capsules (Cinnamomi Ramulus,Poria,Epimedii Folium,etc.) on autophagy proteins of Beclin-1 and LC3-Ⅱ in adjuvant-induced arthritis rats and to explore the possible mechanism of action.METHODS Sixty SD rats were randomized into six groups:normal group,model group,Wuwei Wentong Chubi Capsules (0.8,1.6,3.2 g/kg) groups and tripterygium glycosides (TPT,40 mg/kg) group.In addition to the normal group,adjuvant arthritis (AA) was induced with Freund's complete adjuvant.From the 2th day after injection of FCA,Wuwei Wentong Chubi Capsules with different doses and TPT were given by gavage once a day for 12 days.At the end of the experiment,ankle-joint samples were taken to examine the degree of AA by HE.Beclin-1 and LC3-Ⅱ mRNA were determined by real-time fluorescent quantitative PCR.Meanwhile,the protein expression levels of Beclin-1 and LC3-Ⅱ were determined by immunofluorescence histochemical staining and Western blot.RESULTS As compared with the model group,Wuwei Wentong Chubi Capsules (1.60,3.20 g/kg) not only significantly reduced histopathological injuries,but also effectively up-regulated mRNA and protein expressions of Beclin-1 and LC3-Ⅱ.CONCLUSION Wuwei Wentong Chubi Capsules has a therapeutic action on AA in rats,which might be partly associated with promoting autophagy,decreasing excessive proliferation of synovial cells,leading to the reduction of damage to articular cartilage.