Objective: To study the quality of life (QOL) and its influencing factors of elderly hospitalized terminal patients. Methods: The scale of Life Quality, Social Support Inventory, Life Satisfaction Index A(LSIA), Hospital Anxiety and Depression Scale(HAD), degree of pain (Verbal Report Scale, VRS) and Activities of Daily Living(ADL) were administered in 152 elderly hospitalized terminal patients. Results: 1)The total score of each scale was QOL 36.9?7.4, ADL56.27?34.5,Social Support 40.0?6.3, HAD(A)8.9?4.1,HAD(D)11.2?4.9,LSIA 11.6?3.9?2)Pearson's correlation showed that QOL scores were negatively correlated with degree of pain (r=-0.54,P

Objective To observe the benefits and harms of nilestriol in elderly women with hypertension.Methods Forty-one elderly women with hypertension who had received antihypertensive therapy were randomly divided into two groups. Women in group A (n=21) received oral nilestriol, wherase those in group B(n=20) received oral placebo for six months. Blood sugar(Bs), blood lipids, soluble intercellular adhesion molecule 1(sICAM-1),E-selectin and plasma fibrinogen(Fbg),tissue-type plasminogen activator antigen(tPA),plasminogen activator inhibitor 1(PAI-1),von Willebrand factor(vWF) were measured before starting treatment and 6th month after treatment.Results Levels of total cholesterol(TC),Fbg,tPA,PAI-1,vWF,sICAM-1,E-selectin in group A were significantly lower than those in group B.Conclusions In elderly women with hypertension, nilestriol could improve the metabolism of lipids,endotheliocytes function,inflammation factors expression,thrombosis and hemostasis.

Objective　The aim of this paper was to investigate endothelial dysfunction，platelet activation, and inflammation in elderly hypertensive patients and those complicated with cerebral infarction. Methods　Twenty-eight elderly hypertensive patients complicated with cerebral infarction(within 72 hours after onset of neurological symptoms),thirty-one Stage Ⅰ～Ⅱelderly hypertensive patients and twenty-eight elderly healthy individuals were selected as subjects.Their plasma concentrations of von Willebrand factor(vWF), alpha granule membrane protein-140(GMP-140), and serum concentrations of C-reaction protein(CRP) were examined. Results　Elderly hypertensive patients complicated with cerebral infarction had significantly higher plasma vWF, GMP-140, and serum CRP than elderly hypertensive patients and elderly healthy individuals. Plasma vWF and GMP-140 were higher in elderly hypertensive patients than elderly healthy individuals, whereas serum CRP was increased slightly and there was no significant difference between elderly hypertensive patients and elderly healthy individuals. Conclusion　This study suggests that elderly hypertensive patients complicated with cerebral infarction have obvious endothelial dysfunction, platelet activation, and inflammatory change. Stage Ⅰ～Ⅱ elderly hypertensive patients have obvious endothelial dysfunction and platelet activation as well.

Objective To explore the cost-effectiveness and clinical effect of three platinum based chemotherapy regiments for advanced non small cell lung cancer (NSCLC).Methods 100 patients who were diagnosed as NSCLC,were randomly divided into four groups.The group Ⅰ received NP which was given NVB and DDP.The group Ⅱreceived GP which was given GEM and DDP.The group Ⅲ received TP which was given taxotere and DDP.The clinical effect,adverse reaction and cost effectiveness of the three groups were assessed.Results The clinical effective rates of the three groups were 31.43%,36.36%,37.50% from Ⅰ to Ⅲ group.The adverse events of the group Ⅰ and group Ⅱ were more than those of the group Ⅲ.In the adverse effects of treatment,the major cytotoxicity was digestive reaction and leukopenia in the two groups,but they were tolerable.The ratios of cost effectiveness in the four groups were 550.22yuan,556.48yuan,583.23yuan from Ⅰ to Ⅲ group.Conclusion The NP group is the best one in total cost.

Objective: To analyze the prevalence and changing trend of overweight and obesity among high school seniors in Beijing from 2009 to 2018, and to provide scientific basis for health and education departments to work out effective measures to prevent and control overweight and obesity among adolescents. Methods: The physical examination data of 700 588 high school seniors in Beijing from 2009 to 2018 were selected to describe the distribution characteristics of the detection rate of overweight and obesity, and to analyze whether there are differences in the prevalence of overweight and obesity among different genders and regions. Results: From 2009 to 2018, the prevalence rate of total overweight and obesity of high school seniors in Beijing showed an increasing trend by year ( χ 2=3.58, P <0.01). After 2016, the rising trend was more stable, and it declined for the first time in 2018. The prevalence of overweight ( χ 2=6 681.34, P <0.01) and obesity ( χ 2=15 663.08, P <0.01) were higher in male than in female. The prevalence of overweight and obesity in urban students was higher than that in suburban students (29.55%,27.95%; χ 2=211.43, P < 0.01 ), the prevalence of obesity in urban students was higher than that in suburban students from 2009 to 2013, and the prevalence of obesity in suburban students was higher than that in urban students from 2014 to 2018. The districts and counties with the highest detection rates of overweight and obesity are Shijingshan District (overweight: 19.06%, obesity: 13.99%), and the districts and counties with the lowest detection rates of overweight and obesity are Yanqing District (overweight: 13.48%, obesity: 7.18%). Conclusion From 2009 to 2018, the prevalence of overweight and obesity among high school seniors in Beijing has been increasing by year, and tends to be stable after 2016. Significant upward trend in obesity prevalence in suburban areas of Beijing has been observed.

OBJECTIVE: To analyze the characteristics of left ventricular rotation and twist in patients with essential hypertension (EH) of different left ventricular configurations by 3-dimensional speckle tracking echocardiography (3D-STE). METHODS: A total of 106 EH patients were divided into 4 groups: a left ventricular normal configuration (LVN) group (n=30), a concentric remodeling (CCR) group (n=31), a concentric hypertrophy (CCH) group (n=29), an eccentric hypertrophy (ECH) group (n=16), and a control group of 30 healthy subjects. The parameters of LVEF, peak basal rotation (Prot-B), peak apical rotation (Prot-A), left ventricular peak apical rotation (LV-rot), and left ventricular peak apical twist (LV-tw) were compared. RESULTS: The left ventricular mass index in the EH groups, which kept increasing, was higher than that in the normal control group (P<0.05). Compared with the normal control group, LVN and ECH group, the left ventricular posterior wall thickness, interventricular septum at end-diastole, and relative wall thickness significantly increased in the CCH and CCR group (P<0.05). LVEF showed no significant difference among the normal control, LVN, CCR and CCH group (P>0.05), but LVEF was lower in the ECH group than in other groups (P<0.05). Compared with the normal control group, Prot-B, Prot-A, LVrot and LVtw were significantly higher in the LVN, CCR and CCH group (P<0.05), but decreased in the ECH group (P<0.05). CONCLUSION 3D-STE can evaluate the left ventricular rotation and twist in EH patients with different configurations, and reflect changes in the left ventricular systolic function in EH of different configurations.
Adult ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology ; Ventricular Remodeling ; physiology

Objective:To optimize the scheme and process of chest CT scanning and control the dose level to the examined individuals by establishing the diagnostic reference level (DRL) and warning dose value from chest CT examinations in our hospital.Methods:The medical records for 205 511 examined individuals, who had undergone chest CT scans in the Second Affiliated Hospital of Zhejiang University Medical College from January 1, 2018 to December 31, 2019, were reviewed consecutively. For the two-year examination periods, these examined individuals were divided into two groups, one for 2018 totalling 90 507 and another for 2019 with a total of 115 004. The mean value of doses from chest CT scans in 2018 was set as the DRL for the hospital, with the 75th and 25th percentiles as the upper and lower limits of diagnostic reference range (DRR) and the 97.5th percentiles as the warning dose values. The doses above the upper limit of DRR were considered to be relatively-high whearas the ones exceeding the warning dose value to be over-high. Based on the analysis of the over high dose in 2018, the scanning scheme and inspection process of the chest CT scans were improved in 2019. The number of examinations were estimated for the 2018 period for chest plain CT scans, chest enhancement CT scans, lung cancer screening low-dose CT scans, and relatively-high and over-high dose CT scans, as well as the single scanning doses to the examined in the two groups. The number of examinations resulting in high dose to the examined due to different reasons before and after the improvement were studied. The various parameters on the examined in the two groups were compared statistically.Results:After the improvement, the average dose from chest plain CT scans decreased by 8.67 %, with the statistically significant difference as compared with before improvement ( t=55.71, P<0.05). The average dose from low-dose chest CT scans fell by 20.13% with statistically significant difference ( t=81.99, P<0.05). The fraction of the examinations with slightly-high doses arising from chest plain CT scans and low dose chest CT scans dropped by 3.66% and 17.15%, respectively. The fraction of the examinations with slightly-high dose from chest enhanced CT increased by 1.7%. The fraction of the examinations with over-high dose from chest plain CT scans, enhanced CT scans and low-dose CT scans decreased by 0.55%, 1.06% and 1.74%, respectively. After improvement, the optimized fraction of the examinations with over-high dose, dropped by 4.72%, 31.49% and 19.18% respectively. Conclusions:The establishment of the DRL and the warming dose value of for chest CT examinations in our hospital is helpful to find out the cause of high dose scanning, promote the optimization of dose, reduce the average dose to the examinedes, and avoid using excessive dose during scanning.

Objective To investigate the effects of atorvastatin calcium on thyroid function,im-mune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase(JNK/p38 MAPK)signaling pathway in rats with hypothyroidism.Methods A total of 30 healthy adult male SD rats were randomly divided into control group,hypothyroid group(PTU group)and atorvastatin calcium treatment group(ACT group),with 10 rats in each group.Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days;instead of PTU,rats in the control group were injected subcutaneously with 0.3 mL of saline.After 2 weeks of PTU treatment,rats in the ACT group were gavaged with 3 mL of atorvastatin calcium sa-line solution(containing 5 mg/kg of atorvastatin calcium),which was administered once daily;the control group was gavaged with an equal amount of saline in the same way.The body weight,food intake and water intake of rats were measured weekly.The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group.Enzyme-linked immunosor-bent assay(ELISA)was performed to determine the levels of triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),interferon γ(IFN-γ)and interleukin-4(TL-4)in ser-um;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was performed to de-tect the mRNA expression levels of IFN-γ,IL-10,Foxp3 and IL-4;western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK.Results Compared with control group,PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption(P＜0.05).After 2 weeks of treatment with atorvastatin calcium,the body mass loss of PTU rats was inhibited,food and water consumption was improved,and the differences were sta-tistically significant(P＜0.05).Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats(P＜0.05).Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU,and increase follicular size(P＜0.05).Af-ter treatment with atorvastatin calcium,the spleen mass of PTU rats increased significantly,and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly,but the expression levels of IL-10 mRNA,Foxp3 mRNA and IL-4 mRNA increased significantly(P＜0.05).After treatment with atorvastatin calcium,the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypo-thyroid rats decreased significantly(P＜0.05).Conclusion Atorvastatin calcium treatment for hy-pothyroidism has the function of promoting the normalization of thyroid hormone imbalance,balan-cing Th1/Th2 cytokines,and inhibiting the activation of JNK/p38 MAPK signaling pathway.

Objective To investigate the effects of atorvastatin calcium on thyroid function,im-mune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase(JNK/p38 MAPK)signaling pathway in rats with hypothyroidism.Methods A total of 30 healthy adult male SD rats were randomly divided into control group,hypothyroid group(PTU group)and atorvastatin calcium treatment group(ACT group),with 10 rats in each group.Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days;instead of PTU,rats in the control group were injected subcutaneously with 0.3 mL of saline.After 2 weeks of PTU treatment,rats in the ACT group were gavaged with 3 mL of atorvastatin calcium sa-line solution(containing 5 mg/kg of atorvastatin calcium),which was administered once daily;the control group was gavaged with an equal amount of saline in the same way.The body weight,food intake and water intake of rats were measured weekly.The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group.Enzyme-linked immunosor-bent assay(ELISA)was performed to determine the levels of triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),interferon γ(IFN-γ)and interleukin-4(TL-4)in ser-um;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was performed to de-tect the mRNA expression levels of IFN-γ,IL-10,Foxp3 and IL-4;western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK.Results Compared with control group,PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption(P＜0.05).After 2 weeks of treatment with atorvastatin calcium,the body mass loss of PTU rats was inhibited,food and water consumption was improved,and the differences were sta-tistically significant(P＜0.05).Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats(P＜0.05).Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU,and increase follicular size(P＜0.05).Af-ter treatment with atorvastatin calcium,the spleen mass of PTU rats increased significantly,and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly,but the expression levels of IL-10 mRNA,Foxp3 mRNA and IL-4 mRNA increased significantly(P＜0.05).After treatment with atorvastatin calcium,the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypo-thyroid rats decreased significantly(P＜0.05).Conclusion Atorvastatin calcium treatment for hy-pothyroidism has the function of promoting the normalization of thyroid hormone imbalance,balan-cing Th1/Th2 cytokines,and inhibiting the activation of JNK/p38 MAPK signaling pathway.

OBJECTIVETo examine cerebral pathologies in cerebral amyloid angiopathy in a rat model of Alzheimer's disease.

METHODSRat models of Alzheimer's disease was established by stereotactic Aβ1-42 fiber injection in the bilateral hippocampus. The cognitive function of the rats was evaluated with water maze test. HE staining, Congo red staining and double-labeling indirect immunofluorescence were used to examine the dynamic distribution of Aβ fiber deposit in the brain.

RESULTSThe model rats showed significant differences from the control rats in the escape latency and the times of crossing platform in waster maze test. HE staining revealed a decreased number and degeneration of the granular cells with increased glial cells in the model rats. Congo Red staining showed that the Aβ fiber was deposited gradually in the small vessels in the brain parenchyma to cause thickening, stenosis or occlusion of the small vessels. Immunofluorescence staining detected Aβ fiber migration from the parenchyma to the walls of the small arteries in the rat models.

CONCLUSIONCerebral amyloid angiopathy is a major pathological feature in Alzheimer's disease.

Alzheimer Disease ; pathology ; Amyloid beta-Peptides ; chemistry ; Animals ; Brain ; pathology ; Cerebral Amyloid Angiopathy ; pathology ; Disease Models, Animal ; Rats ; Staining and Labeling