Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.

Objective To investigate the role and possible mechanism of P120 catenin involving in the hemodynamic changes by inducing vascular endothelial cells injury through an in vitro experiment. Methods The hemodynamic environment under the different hemodynamic conditions at the vascular bifurcations was simulated through a T-shaped flow chamber system designed by ourselves. The human umbilical vein endothelial cells (HUVEC)cultured in vitro were stimulated and used the HUVEC cells of the small interfering RNA (SiRNA)after P120ctn gene fragments being knocked out. After loading flow rate of 250 and 500 ml/ min respectively and acting on for 12 h,the HUVEC morphology,growth pattern,and expression of P120ctn and other proteins were observed. Results (1)Normal HUVEC:500 ml/ min was loaded for 12 h,the cells were fused excessively at the impinging point,the cell gaps became narrowed,the cell density decreased and the morphology was elongated in the high wall shear stress (WSS)and wall
shear stress gradient (WSSG)regions. A part of cells migrated downstreamly,and their arrangement direction was consistent with the direction of impinging flow. Compared with the unloaded impinging flow field,after the 2 kinds of impinging flows being loaded for 12 h,the expression levels of P120ctn,vascular endothelial calcium (VEC),Kaiso,α-catenin,and other proteins were decreased. The expression level of matrix metalloproteinase 2 (MMP-2)was increased. There were significant differences (all P < 0. 05). (2)HUVEC after P120ctn being knocked out:Under the impact of the impinging flow,the cell growth time was reduced to 60 min. 250 ml/ min being loaded for 60 min,the impinging point and its surrounding cells still maintained the polygon,but some cells in the high WSS and high WSSG regions began to move downstreamly and aggregated,the cell arrangement mode partly arranged along with the direction of the flow;500 ml / min being loaded for 60 min,the cell density in the high WSS and high WSSG regions were decreased significantly and the morphology was elongated. A large number of cells migrated downstreamly and aggregated. The arrangement mode was parallel and consistent with the direction of the impinging flow. Compared with the unloaded impinging flow field,after the 2 kinds of velocities being loaded for 60 min,the expression levels of VEC,Kaiso,α-catenin proteins were decreased. The expression level of MMP-2 was increased,There were significant differences (all P < 0. 05) Conclusions The hemodynamic change may induce the changes in vascular endothelial cell morphology,growth pattern,and expression of P120ctn and other related proteins, leading to the decrease of vascular endothelial cell adhesion connection stability and the expression changes of related proinflammatory factors. The knockout of P120ctn may result in a further decrease of the vascular endothelial cell adhesion connection stability.

Objective To determine whether pattern of WT1 gene expression is a useful marker for establishing prognosis and tracking disease progression in patients with myelodysplastic syndromes (MDS). Methods RNA were extracted from bone marrow smears of 45 patients with MDS, the WT1 expression were tested by FQ-RT-PCR. Results The degree of WT1 expression was increased during disease progression of MDS. The WT1 expression level was increased more a logarithm grade when a RA patient developed into RAEB, the fluctuation of WT1 expression level was decreased a logarithm grade during RA. Conclusion WT1 gene is a useful marker for assessment in MDS patients. It pointed out may diagnosis RA if the WT1 expression level higher two logarithm grade than the mean of normal control for patients which didn't diagnose by morphology. It may suggest disease progress of MDS if the WT1 expression level increased more a logarithm grade recently. Further confirmation was needed because the case was limited.

Objective To observe the clinical effect of Chinese herbal medicine gargle on the prevention of aspiration pneumonia in elderly patients with long-term nasal feeding. Methods 93 elderly patients over 60 years old with indwelling nasogastric tube for 30 days were randomly divided into 48 cases of the experimental group and 45 cases of the control group. We compared incidence of aspiration pneumonia of the elderly patients with long-term nasal feeding in two groups of oral care solution by using the self-made traditional Chinese medicine gargle for oral nursing in the experimental group and treated with saline in the control group. Results The oral bacterial colony count and the incidence of aspiration pneumonia in the experimental group were lower than those in the control group, with two different kinds of nursing fluid. Conclusion Using the self-made traditional Chinese medicine gargle for oral care, could effectively reduce the number of oral bacteria, reduce the incidence of aspiration pneumonia, the application effect is good, and could be in clinical promotion and application.

This article was aimed to study the optimum extraction process of paeonol. The extraction yield of paeonol was taken as investigation index. And the best extraction process was screened by orthogonal experimental design. The results showed that the optimum condition of extraction process was to soak coarse powder of Paeonia suffruti-cosa into 15-fold water for 0.5 h, and then the distillation lasted for 2.5 h. The distillate was collected and cooled to room temperature. The crystallization lasted for 24 h at 4℃, and then filtered and dried for 48 h at room tempera-ture. It was concluded that the selected technology was stable, reasonable and feasible. The extraction yield of paeonol is over 80%.

Objective To investigate the correlation between D-dimer and high sensitivity C reactive protein for elderly patients with coronary artery disease. Methods A total of 162 cases of elderly patients with coronary artery disease pa-tients were selected from internal geriatric department in our hospital, according to the classification, all patients were divided into stable angina pectoris (SAP group), coronary heart disease unstable angina pectoris (UAP group), non ST segment elevation myocardial infarction (NSTEMI group) and ST segment elevation myocardial infarction (STEMI group), all serum high sensitivity C reactive protein and D-dimer level were detected by immune turbidimetric method, the impact on clinical cardiovascular adverse events and the severity of coronary lesions (Gensini score) relationship were analyzed. Results High sensitive C reactive protein, D-dimer level of STEMI group single and combined detec-tion positive rate were significantly higher than SAP group, UAP group and NSTEMI group, the above indices of NSTE-MI group were significantly higher than SAP group and UAP group, the above indices of UAP group were significantly higher than SAP group with statistically significant differences between groups (P<0.05), the combined positive rate were significantly higher than single detection, compared with significance (P<0.05), clinical cardiovascular adverse events of high C levels group was significantly higher than low C group, high D group was significantly higher than low D group, compared with significant differences (P<0.05), the Pearson correlation analysis showed that, high sensitive C reactive protein and D-dimers were positively correlated (r=0.51, P=0.03), both of which were related to the Gensini score was positively(r=0.46, 0.52, P=0.04, 0.03). Conclusion High sensitivity C reactive protein, D-dimer are significant difference in different types of elderly coronary heart disease, both are positively correlated with the severity of coronary artery disease, and has an important role in the evaluation of occurrence of clinical adverse cardiovascular events.

We sought to explore the feasibility of global area strain to assess left ventricular global systolic function in patients with essential hypertension and normal ventricular geometry. Thirty-five essential hypertensive patients with normal ventricular geometry and 30 normally healthy persons as controls were enrolled in this study. The two groups were comparable for age, sex ratio, height, weight, body mass index (BMI), and heart rate. Blood pressures (BPs) were significantly higher in the hypertension group than the control group. Two-dimensional echocardiography and three-dimensional speckle tracking imaging were performed. Left ventricular global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), LV volumes, ejection fraction (EF), sphericity index (SPI), left ventricular end-diastolic and end-systolic mass (EDmass and ESmass) and LV mass index (EDmassI and ESmassI) were obtained. Compared with those of the controls, GAS, GLS, GCS, GRS were significantly reduced in hypertensive patients Call P < 0.001). GAS (r = 0.672, P < 0. 001), GLS (r = 0.587, P < 0.001), GCS (r = 0.639, P < 0.001) and GRS (r = 0.685, P < 0.001) were correlated with EF in the pooled population. GAS showed an excellent correlation with GCS (r = 0.905, P < 0.001), GLS (r = 0.892, P < 0.001) and GRS (r = 0.990, P < 0.001). EF measured with 3D-STI was significantly lower in group of hypertension (P < 0.001) than that in the controls. There were no significant differences between the two groups in cardiac output, sphericity index, EDmass and ESmass, LV mass index (EDmassI and ESmassI) calculated with 3D-STI. The study showed that GAS could identify early changes of left ventricular global systolic function in hypertensive patients with normal ventricular geometry.
Adult ; Aged ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

Objective: To investigate the clinical characteristics, cell morphology, genetics, gene mutations of the patients with chronic neutrophilic leukemia (CNL). Methods: Five CNL patients from the Second Hospital of Shanxi Medical University between May 2011 and May 2017 who conformed to 2016 World Health Organization (WHO) diagnostic criteria were retrospectively analyzed from clinical characteristics, laboratory features and treatment methods. Results: The peripheral blood white blood cell count (WBC) of 5 CNL patients was significantly increased, and the average WBC was 81.26×10⁹/L [(29-217)×10⁹/L]. Morphological analysis of peripheral blood cell showed a sustained increasing number of matured neutrophilia (0.80-0.85). Neutrophil alkaline phosphatase (NAP) activity was increased (144-266). Bone marrow cell morphology typically showed granulocyte proliferation without obvious dysplasia. Gene detection showed 3 patients with CSF3R T618I mutation and 2 patients with JAK2 V617F mutation in 5 WHO-defined CNL patients. Bone marrow biopsy with reticular staining showed that marrow fibrosis (MF) degree in patients with JAK2 V617F mutation (MF≥2) was higher than that in patients with CSF3R T618I mutation(MF<2). Conclusions CNL is a rare type of chronic leukemia, and CSF3R T618I mutation is a specific diagnostic index for CNL. JAK2 V617F mutations alone may be related to myelofibrosis, which remains to be further studied.

Objective:To investigate the early predictive value of lupus anticoagulant (LA) ratio, D-dimer (D-D) and soluble endothelial protein C receptor (sEPCR) on deep vein thrombosis (DVT).Methods:Thirty hundred and fifty patients who performed surgery for lower extremity fracture and suspected DVT in Zhejiang Rongjun Hospital from October 2018 to October 2019 were enrolled. With deep vein contrast of the lower extremity as the gold standard, 82 patients with confirmed DVT were treated as the observation group and 268 patients without DVT as the control group. The levels of LA, D-D and sEPCR of two groups were detected by coagulation, immunoturbidimetry and enzyme linked immunosorbent assay—sandwich technique respectively. Indexes of the two groups were compared. Pearson correlation was used to analyze the relationship between plasma levels of LA, D-D and sEPCR, and the predictive value of plasma sEPCR, LA ratio and D-D level on DVT was evaluated by receiver operator characteristic (ROC) curve.Results:The plasma sEPCR, LA ratio and D-D levels in the observation group were significantly higher than those in the control group [(143.30 ± 11.28) μg/L vs.(112.56 ± 14.62) μg/L, 1.51 ± 0.24 vs. 1.22 ± 0.18, (1 013.00 ± 319.54) μg/L vs. (425.17 ± 100.36) μg/L] with statistically significant differences ( P < 0.05). There was no significant differences in activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) between the two groups ( P > 0.05). In the observation group, plasma sEPCR level was positively correlated with LA ratio and D-D level ( r = 0.280, P = 0.011; r = 0.563, P < 0.001), and LA ratio was positively correlated with D-D level( r = 0.741, P < 0.001). The area under curve (AUC) of D-D in diagnosis of DVT was 0.940, and the sensitivity and specificity were 87.80% and 87.69% when the cut-off value was 569.43 μg/L. The AUC of LA ratio in the diagnosis of DVT was the smallest, which was 0.912, the sensitivity and specificity were 87.80% and 91.25% when the cut-off value was 1.23. The sensitivity was 95.12% and specificity was 95.00% of sEPCR and LA ratio combined with DD in diagnosis of DVT. Conclusions:LA and D-D combined with sEPCR has high predictive value for DVT.

Objective: To investigate cardiovascular disease (CVD) prevention status among residents with intra-urban migration in Central China, so as to provide insights into targeted prevention and control of CVD. Methods: Basic data of residents aged 35 to 75 years who participated in Early Screening and Comprehensive Intervention Project for CVD high-risk populations in Central China from September 2015 to August 2020 were collected. According to birth place, type of registered residence and current residence, residents were divided into four groups: local residents in old urban area, local residents in new urban area, other urban migrants and other rural migrants. The status of CVD primary and secondary prevention, were analysed by using a robust Poisson regression model. Results: A total of 76 513 residents were recruited, including 29 420 males (38.45%) and 47 093 females (61.55%), and had a mean age of (56.36±9.84) years. There were 45 087 (58.93%) local residents in old urban area, 23 868 (31.19%) local residents in new urban area, 5 668 (7.41%) other urban migrants and 1 890 (2.47%) other rural migrants. After adjusting for variables such as age, gender and educational level, the results of robust Poisson regression analysis showed that compared with local residents in old urban area, local residents in new urban area had lower compliance rates of non- or moderate-drinking (RR=0.987, 95%CI: 0.975-1.000) and healthy diet (RR=0.535, 95%CI: 0.365-0.782), lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.616, 95%CI: 0.511-0.741), lower awareness (RR=0.873, 95%CI: 0.782-0.974) and control rates (RR=0.730, 95%CI: 0.627-0.849) of hypertension; other urban migrants had higher compliance rate of non-smoking (RR=1.045, 95%CI: 1.017-1.075); other rural migrants had lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.826, 95%CI: 0.707-0.966). Conclusion The CVD primaryprevention among local residents in new urban area is relatively poor among four groups of residents in Central China, and key interventions are needed.