Objective:To study the current status and needs of Community Care for disabled elderly in Beijing and put forward the suggestions for improving the elderly Community Care system. Methods:Descriptive statistical a-nalysis, Chi-square test and Multivariate logistic analysis were adopted to analyze the situation of Community Care for Disabled elderly using data from the community survey of elderly population in Beijing. Results:The status of health is not optimistic for Disabled elderly, there are high demands for the community health services and welfare facilities for elderly and the needs for services provided by part-time home care, day care and volunteers are high, but those services and facilities provided by communities were found to be inadequate. Conclusion:China has a large popula-tion base of Disabled elderly and its number grows fast, but community care supply is in shortage and cannot meet the needs of those people. It is therefore urgent to improve community health services and community care system.

Objective:To understand the state of Chlamydia pneumoniae (Cpn) infection in patients with coronary hear disease (CHD), and explore the relationship between Cpn infection and the gonesis and progressin of CHD.Methods:By means of PCR and ELISA, Cpn IgG antibody and nucleic acid were detected in 159 patients with CHD and 41 control subjects.Results:The positivity rate of Cpn DNA was 43 40%(69/159) in the patient group and 7 32%(3/41) in the control group, showing obvious difference between the two groups( P

Objective: To observe the efficacy of skin regenerative medical technique in treating proliferative scars. Method: Select 32 patients (age16-52) with proliferative scars after burns or wound for 1-11 years,which include 25(male) and 7(female). 2 scar similar spots are chosen in each patient for self-comparison.After the experimental group uses the scar detachment, scar Pi Huizhi applies the beautiful valuable moist burn medicinal plaster gauze cover the cooperation of Chinese and Western medicine home position skin regenerative method treatment; After the control group uses the scar detachment, scar Pi Huizhi applies the petroleum jelly cover the traditional method treatment.The observation comparison curative effect, applies the Vancouver scar appraisal meter appraisal scar proliferation situation. Results: Two groups return to the scar skin which plants to survive.The experimental group regenerates the skin to be good, the cicatrization speed and the quality surpass the control group (P

Objective To explore the feasibility of single port laparoscopy in classification and treatment of Meckel's diverticulum in children and its guiding treatment.Methods The clinical data in 75 children cases of Meckel's diverticulum with symptoms treated in our hospital from Aug.2011 to Aug.2015 were retrospectively analyzed.Meckel's diverticulum was classified under single port laparoscopy.The operation modes were selected according to different classifications.The excised materials were submitted to the pathologic examination.Results Among 75 children cases,50 cases were the simple type of Meckel's diverticulum and 25 cases were complex type of Meckel's diverticulum.The average operative time in the simple type and complex type was (38.93±8.75) min and(55.64 ± 13.27) min respectively,average bleeding amounts were (46.58 ± 15.81) mL and (50.12 [16.90) mL respectively,average postoperative hospitalization time was (7.33±1.41)d and (7.52 ± 1.68)d respectively,the operative time in the simple type was less than that in the complex type(P＜0.05),the other two indexes had no statistical difference between the two groups(P＞0.05).The ectopic gastric mucosal pathological change was only seen in the simple type,while the inflammatory manifestation in the complex type had higher proportion.The main clinical manifestations were lower gestational tract bleeding and infection.The two groups all obtained follow up.One case of simple type appeared the symptoms of abdominal pain and hematochezia and was cured after the second operation.Conclusion Meckel's diverticulum can be divided into the simple type and complex type under single port laparoscopy.The operation mode can be selected according to different types.This method is safe and reliable and is worthy of being clinically promoted.

OBJECTIVETo study the relationship between carbon dioxide combining power(CO₂-CP) and contrast-induced acute kidney injury (CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.

METHODSWe retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention. Patients were divided into three tertiles according to pre-operative CO₂-CP: T1 (CO₂-CP < 22.62 mmol/L), T2(CO₂-CP 22.62-24.30 mmol/L), T3(CO₂-CP > 24.30 mmol/L). Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups. An increase in serum creatinine of >26.4 µmol/L and/or >50% from baseline within 48 hours after contrast exposure was defined as CI-AKI. Univariate logistic regression analysis was used to identify the risk factors of CI-AKI. The relationship between CO₂-CP and CI-AKI was assessed by multivariate logistic regression analysis. Receiver operating characteristic curve was used to identify the optimal cutoff of the CO₂-CP for predicting CI-AKI.

RESULTSCI-AKI occurred in 25 (14.4%) patients, and lower CO₂-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3% (3/57) in group T2, 1.7 % (1/59) in group T3, P = 0.002) and higher in-hospital mortality (10.3% (6/58) vs. 0 and 1.7% (1/59), P = 0.010). Dialysis rate was similar among 3 groups (5.2% (3/58) vs. 0 and 1.7% (1/59), P = 0.168). The incidence of CI-AKI was significantly associated with CO₂-CP < 22.00 mmol/L in univariate analyses (OR = 6.767, 95% CI 2.731-16.768, P < 0.001). After adjusting for potential confounding risk factors, CO₂-CP < 22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR = 5.835, 95%CI 1.800-18.914, P = 0.003) in multivariate logistic regression. ROC analysis revealed that the optimal cutoff of CO₂-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%, specificity 79.1%, AUC = 0.714).

CONCLUSIONSPre-percutaneous coronary intervention CO₂-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI. CO₂-CP < 22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.

Acute Kidney Injury ; etiology ; Carbon Dioxide ; analysis ; Contrast Media ; Hospital Mortality ; Humans ; Incidence ; Kidney ; Logistic Models ; Myocardial Infarction ; complications ; physiopathology ; Percutaneous Coronary Intervention ; ROC Curve ; Retrospective Studies ; Risk Factors

Objective To study the relationship between carbon dioxide combining power ( CO2-CP) and contrast-induced acute kidney injury ( CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.Methods We retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention.Patients were divided into three tertiles according to pre-operative CO2-CP: T1 (CO2-CP <22.62 mmol/L),T2(CO2-CP 22.62 -24.30 mmol/L), T3(CO2-CP>24.30 mmol/L).Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups.An increase in serum creatinine of >26.4 μmol/L and/or >50%from baseline within 48 hours after contrast exposure was defined as CI-AKI.Univariate logistic regression analysis was used to identify the risk factors of CI-AKI.The relationship between CO 2-CP and CI-AKI was assessed by multivariate logistic regression analysis.Receiver operating characteristic curve was used to identify the optimal cutoff of the CO 2-CP for predicting CI-AKI.Results CI-AKI occurred in 25(14.4%) patients, and lower CO2-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3%(3/57) in group T2, 1.7 % (1/59) in group T3, P=0.002) and higher in-hospital mortality (10.3%(6/58) vs.0 and 1.7%(1/59), P=0.010).Dialysis rate was similar among 3 groups (5.2%(3/58)vs.0 and 1.7%(1/59), P=0.168).The incidence of CI-AKI was significantly associated with CO2-CP<22.00 mmol/L in univariate analyses ( OR=6.767,95%CI 2.731-16.768, P<0.001).After adjusting for potential confounding risk factors , CO2-CP <22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR=5.835,95%CI 1.800-18.914, P=0.003) in multivariate logistic regression.ROC analysis revealed that the optimal cutoff of CO 2-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%,specificity 79.1%, AUC=0.714).Conclusions Pre-percutaneous coronary intervention CO 2-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI.CO2-CP<22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.

Objective:To evaluate the application effect of a series of optimized nursing measures under the concept of enhanced recovery after surgery (ERAS) on the perioperative period of patients with posterior cervical single-door spinal canal augmentation and angioplasty.Methods:A retrospective cohort study design was used. From April to December 2018, using cluster sampling method, 476 patients admitted to a class third hospital for posterior cervical single-door spinal canal augmentation and angioplasty were selected as research objects. According to whether or not to implement ERAS optimization, the patients were divided into ERAS group with 100 cases and control group with 376 cases. The control group underwent routine measures such as preoperative evaluation and education, blood management, anesthesia points, surgical points, incision closure, pain management, drainage tube management, and prevention of complications. On the basis of routine measures, the ERAS group implemented optimized measures for ERAS on clinical measures such as fasting water and infusion management before surgery, postoperative diet and infusion management, bowel preparation, urinary tube management, and out of bed activities. A self-designed questionnaire was used to investigate the two groups of patients. The general information, implementation of ERAS nursing (preoperative fasting time, the preoperative water cut-off time, the time for anesthesia, the time for surgery, the amount of infusion before surgery, the amount of infusion during surgery, the amount of infusion after surgery, use of indwelling urinary catheters) , recent effect evaluation indicators [length of hospitalization, cost of hospitalization, discharge daily living ability score (Barthel index) , postoperative complications, postoperative urinary retention]and long-term effect evaluation indicators [Japan Orthopedic Association (JOA) score, Neck Disability Index (NDI) score, neck and shoulder pain VAS score, neck and shoulder stiffness and numbness VAS score, 90-day readmission rate]of the two groups were compared.Results:A total of 295 cases were included in the study, including 69 cases in the ERAS group and 226 cases in the control group. The study found that there were statistically significant differences between the two groups of patients in terms of preoperative fasting time, the preoperative water cut-off time, the amount of infusion before surgery, the amount of infusion after surgery and the use of indwelling urinary catheters ( P<0.05) . The comparison of recent effects showed that the difference in length of hospitalization and Barthel index between the two groups were statistically significant ( P<0.05) , while there was no significant difference in the incidence of postoperative complications of the two groups ( P>0.05) . The comparison of long-term effects showed that there was no significant difference in the modified JOA score, NDI score, neck and shoulder discomfort and the 90-day readmission rate in the two groups ( P>0.05) . Conclusions:The application of ERAS nursing in the perioperative period of patients with posterior cervical single-door spinal canal augmentation and angioplasty can effectively reduce patients' fasting time and water cut-off time, use of urinary catheters, which can reduce patients' hospitalization time, but has no significant effect on the long-term effect of surgery.

BACKGROUNDThoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease. However, the clinical manifestations of systemic inflammatory response after TEVAR as post-implantation syndrome (PIS) resemble the perioperative infection. This study aimed to evaluate changes and diagnostic value of procalcitonin (PCT) and other traditional inflammatory markers for infections after TEVAR.

METHODSWe conducted a prospective clinical study that enrolled 162 consecutive aortic dissection cases, who underwent TEVAR in our institution between July 2011 and November 2012. The PCT, C-response protein (CRP), erythrocyte sedimentation rate (ESR) and blood routine examination were monitored before the operation and on days 1, 2, 3 and 5 after the operation. The diagnosis of infection was confirmed by the infection control committee with reference to Hospital Acquired Infection Diagnostic Criteria Assessment, released by the Ministry of Health of the People's Republic of China.

RESULTSPost endovascular repair of thoracic aorta, PCT changes significantly at different time points (χ(2) = 13.225, P = 0.021), without significant difference between the PIS group and the control group (0.24 ± 0.04 vs.0.26 ± 0.10, P = 0.804). PCT values were significantly higher in the first day after TEVAR than the preoperative levels (0.18 ± 0.03 vs. 0.11 ± 0.02, P < 0.001). Compared with PIS patients, the level of PCT, CRP, White blood cell (WBC) and neutrophil (NEU) in the infection patients elevated significantly (relatively χ(2) = 6.062, P = 0.048; χ(2) = 6.081, P = 0.048; χ(2) = 11.030, P = 0.004; χ(2) = 14.632, P = 0.001). According to the ROC analysis, the PCT levels in the first day after TEVAR (AUC = 0.785, P = 0.012) had better predictive values of infection than WBC, NEU CRP and ESR (AUC = 0.720, P = 0.040; AUC = 0.715, P = 0.045; AUC = 0.663, P = 0.274; AUC = 0.502, P = 0.991). The best predictive index was the changes of PCT between preoperative and postoperative (PCT), which possess AUC as 0.803 (P = 0.014). And PCT = 0.055 could be considered as an infection diagnosis cutoff value with a sensitivity of 83.3% and specificity 69.0%.

CONCLUSIONSPCT provides better diagnostic value of infection compared with other inflammatory markers. The potential applications of PCT in differential diagnosis of PIS and infection after percutaneous TEVAR deserve further studies.

Adult ; Aged ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Calcitonin ; metabolism ; Calcitonin Gene-Related Peptide ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Protein Precursors ; metabolism ; Vascular Surgical Procedures

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.