Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

After the initial episode of acute pancreatitis (AP), some patients have a tendency to relapse.With the development of imaging technologies and genetic tests, the diagnostic accuracy of the etiological factors of recurrent acute pancreatitis (RAP) such as dysfunction of sphincter of Oddi, pancreas divisum, and genetic mutations are improved.Clinical studies indicate that etiological treatment by endoscopic approaches may reduce recurrence in some RAP patients.In this article, the progress in etiology, diagnosis and treatment of RAP was reviewed.

Objective To study clinical and pathological characteristics and effects of arthroscopic treatment of ankle soft tissue impingement syndrome(ASTIS). Methods A total of 21 cases of ASTIS underwent arthroscopic operations from November 2000 to April 2005.The impingement soft tissues were removed under arthroscope at 13.6?9.9 months after injury.The resected tissues were pathologically examined following surgery.The efficacy of arthroscopy was assessed using the American Orthopaedic Foot and Ankle Society(AOFAS) rating scores. Results Arthroscopic findings showed the most common impingement tissue was synovium(20 cases),followed by distal fascicle of the anterior tibiofibular ligament(5 cases),fibrous scar tissue(4 cases),anterior talofibular ligament(3 cases),and meniscoid tissue(3 cases).ASTIS accompanying cartilage injuries was found in 16 cases.All the cases were followed for 7~60 months(mean,34.3?9.4 months).The AOFAS scores significantly increased postoperatively than preoperatively,with total scores from 67.0?9.7 to 94.0?6.4(t=-7.205,P=0.000) and subjective scores from 20.7?6.6 to 35.7?4.9(t=-5.003,P=0.000). Conclusions Ankle soft tissue impingement syndrome often occurs after ankle sprain along the anterolateral portion of the ankle.Common impingement tissues are synovium,ligament,scar tissue,and meniscoid tissue.Arthroscopic treatment of ankle soft tissue impingement syndrome is satisfactory.

MicroRNA-7(miR-7)was firstly found in Drosophila melanogaster,which participated in the formation of Drosophila wings,eggs and so on.In human being miR-7 is not only involved in cell prolifera-tion and differentiation,but also plays an important role in the development of tumor,especially in lung cancer. Most studies report that miR-7 is low expression in lung cancer with poor prognosis.Improving the expression of miR-7 can inhibit tumor growth.MiR-7 can regulate the expression of BCL-2,EGFR negatively,meanwhile it can regulate the sensitivity of tumor cells to radiotherapy chemotherapy and targeted therapy.Therefore,as a tumor suppressor,miR-7 is expected to become a new target for treatment of lung cancer.

Objective To provide rational use of vancomycin in elderly MRSA-infected patients, compared its pharmacokinetics in the elderly MRSA-infected patients with healthy young subjects.Methods 15 elderly MRSA-infected patients and 15 healthy young subjects were injected with 1.0g vancomycin.Serum concentrations were determined by fluorescence polarization immunoassay(FPIA) in both groups(n infected=15,n healthy =15),then calculated the pharmacokinetic parameters with program 3p97.Results Compared with the healthy group, the elimination half life (t1/2β)were longer, the apparent volume of distribution (Vd)and the area under curve(AUC)were increased,the creatinine clearance(Ccr)were lower in the infected group.The differences of these pharmacokinetic parameters between the two groups were statistically significant(p<0.01) except the peak serum concentrations(p>0.05).Conclusion Vancomycin should be used with decreased dose or increased interval in the elderly MRSA-infected patients, therapeutic drug monitoring and personalized medicine were required.

Objective: To investigate the interactions between carbohydrate derivatives and sodium-glucose cotransporters 2 (SGLT2) using molecular dynamic (MD) method and to explore the mechanisms and structure-activity relationship of SGLT2 inhibitors. Methods: The homologous structure of SGLT2 was modeled, the GROMACS program was used to model eight structures, such as SGLT2, SGLT2-glucose compound, and SGLT2-carbohydrate compound. And the root mean square fluctuation (RMSF) of the key residues and ligands and the interaction energy between the ligands and SGLT2 was investigated by trajectory analysis. Results: The interaction energy calculated by MD method had the higher correlation with experimental results than that by molecular docking method. H80, K154, D158, and Y290 were the key residues involved in the interaction, N75 and F453 were the important residues, and W291, Q295, and S393 might be the auxiliary residues. The ligands had a relatively consistent conformation, and fragments A and C played the more important roles in receptor binding. And the size, rigidity, and polarity increasing could elevate the bonding strength. Conclusion: MD simulation results could display the good performance of the interaction between the ligands and SGLT2, and could give clear guidance for the design of new SGLT2 inhibitors.

Objective Using accurate monitoring,and high precision anesthetic machine and vapourizer,and guided with a simple mathematics formula to implement low-flow inhaled anesthetic techniques.Methods Ten healthy patients under going craniotomy,thoracotomy or laparotomy were assigned to receive isoflurane by low-flor of fresh gas and high vapourizer output.After intubation,the vapourizer dial was set at 5% and the patients were delivered with 1L/min total fresh gas flow of oxygen.The expiratory(F E) and inspired(F 1) concentration of isoflurane were monitored continuously.The data were recorded with computer once every 10. The concentrations were plotted against the time and the predicted regression equation were calculated.Results The F E reached 1.05% 10 min after inhalation of isoflurane ,which could be predicted by curvilinear(y=0 4092(1nx)+0 0172) and lineal (y=0 083x+0 1385) regression equations from 1 to 10 min,The predicted concentration by curvilinear regression equation appeared to estimate the measured value more accurately than linear regression equation.However segmental lineal regression equation cluld predict the measured value as accurately as curvilinear regression equation.Conclusions The inhalation anesthetic induction can be completed within 10 min with low-flow of fresh gas flow and high output of vapourizer dial setting.The measured value of anesthetic can be predicted accurately.

This article summarized the clinical researches on heat-sensitive moxibustion for the treatment of knee osteoarthritis from the aspects of simple heat-sensitive moxibustion and heat-moxibustion combined with other therapies. It analyzed the advantages and disadvantages of the clinical application of heat-sensitive moxibustion, and discussed the ways of better using heat-sensitive moxibustion, with a purpose to inherit and develop it in clinical practice more efficiently.

Based on the theory of organizational performance appraisal and the needs of developing China's hospital performance assessment system, the paper proposed the concept and emphasized the significance of establishing a comparative hospital performance assessment system in China. By sharing identical experiences from overseas, the paper also advocates that as China is building its comparative hospital performance assessment framework, it is imperative to verify the comparability of hospital performance assessment indicators, build a quality-centered comparative model for hospital performance assessment, and a three-tier comparative model to cover hospitals, departments and posts. These efforts will further improve China's performance assessment system.

Objective Orthogonal design was employed to determine the best techniques in processing Carbonized Imperata Cylindrical. Methods UV was used to detect the absorption force and tannis in Carbonized Imperata Cylindrica by different kinds of processing methods. Results The best technique is to bark the drug for 4 minutes at 270 ℃. Conclusion The optimized processing technique was proved to be reasonable by the repeated test.