Objective To understand the life quality of elderly person in communities, nursing homes and elderly wards, and to find out the related influencing factors for providing references for policy-makers to improve the life quality of the elderly. Methods The senior citizens in 9 communities, 3 villages, 12 nursing homes and 5 elderly wards in Shanghai Minhang District were enrolled by stratified cluster sampling. And the life quality and its influential factors among the inhabitants in communities, nursing homes and elderly wards were compared by adopting Short-Form 36 (SF-36) questionnaire. Results Regarding to the life qualities of senior citizens, community showed that physical functioning was (71. 9 ± 23. 3)scores, role physical was (73. 6 ± 43. 0) scores, bodily pain was (80. 2±20. 3)scores, general health was (53. 2± 19. 1)scores, vitality was (70. 4± 15. 7)scores, social function was ( 83. 8 ± 20. 2) scores, role emotional was ( 81. 1 ± 37. 2 ) scores, mental health was (78. 1 ± 15. 4) scores, weighted average was (74. 1 ± 17. 5) scores. Nursing home showed that physical functioning was (42. 1 ±30. 7) scores, role physical was (57. 9 ±48. 1) scores, bodily pain was (78.0±23.0)scores, general health was (50. 2± 19. 5)scores, vitality was (66. 0± 19. 5)scores, social function was (70. 8 ± 26. 3) scores, role emotional was (66. 8 ± 45. 7) scores, mental health was (73. 6 ± 19. 6) scores, weighted average was (63. 2 ± 21. 0) scores. Elderly ward showed that physical functioning was (20. 4 ± 26. 0) scores, role physical was (36. 1 ± 47. 0) scores, bodily pain was (65. 4±29. 5)scores, general health was (43. 1±17. 1)scores, vitality was (59. 0± 18. 0)scores, social function was (57. 9 ± 25. 3) scores, role emotional was (49. 5 ± 48. 7) scores, mental health was (66. 2 ± 18. 3) scores, weighted average was (49. 7 ±18. 3) scores. The major influential factors on the life quality were gender, education, marriage, profession, age, disease, residence, entertainment, physical exercise for community; Age, disease, residence, entertainment, physical exercise for nursing home; Age, etc for elderly ward. Conclusions The influences of demographic factors on life quality of the senior citizens in communities are more significant than in nursing home and elderly wards. Variations on the degree of satisfaction (in residence, entertainment, health care and transportation) and the situation of physical exercise have made vast difference in the life quality of the senior citizens both in communities and nursing homes.

BACKGROUND: There are many treatment approaches of the cervical spinal cord injury but the results were all unpleased.OBJECTIVE: To discuss the effect of the operation and other colligate treatments on the functional recovery of the patients who suffered from the cervical central spinal cord injury.DESIGN: A preoperative and postoperative control study.SETTING: Orthopaedic department in an affiliated hospital of a university.PARTICIPANTS: Eleven male patients of the central spinal cord injury,whose ages ranged from 36 to 65, were chosen from the Orthopedic Department of People' s Hospital of Jiangsu Province from January 1999 to January 2003. Nine cases suffered from traffic accidents. One case suffered from falling injury. One case suffered from head smash injury. The courses of diseases were from 2 hours to 14 days. Nine cases were accompanied with the cervical intervertebral disc herniation. One case was accompanied with the cervical vertebral canal stenosis. One case was accompanied with the fracture of the C6 vertebral body. Nine cases showed single segment injury and 2 cases showed two segment injuries in the MRI plate.METHODS: The operation was done 4 to 20 days after the injury. Anterior cervical intervertebral disc removal, bone implantation and the internal fixation of the armor plate were done in 9 cases. Posterior route cervical vertebral depression, bone implantation and internal fixation of the lateral armor plate were done in 2 cases.tion.RESULTS: Before the operation 11 cases were classified according to the Frankel Grade: 3 cases of 0 grade, 3 cases of Ⅰ grade and 5 cases of Ⅱ grade. After the operation 1 case of 0 grade, 4 cases of Ⅲ grade, and 6 cases of Ⅳ grade. The mean muscular power recovered 2 to 5 grades. The re-examination of the internal fixation was firm and right-located. The implanted bone healed well.CONCLUSION: After the diagnosis of the cervical central spinal cord injury, the colligate treatment is suggested. The operation removes the pathogenic factors as soon as possible, and other assistant treatments promote the functional recovery of the spinal cord.

Objective To evaluate the application and risk of hematogenous tumor dissemination of intraoperative autologous blood salvage on radical nephrectomy for renal carcinoma with inferior vena cava tumor thrombus.Methods Between July 1999 and October 2005,19 patients with renal cell carcinoma invading inferior vena cava were used by the intraoperative autologous blood salvage.Preoperative and postoperative clinical data were analyzed and compared.The blood sparing effect and follow-up were evaluated.Results The intraoperative autologous blood salvage of all cases was successful.The levels of HCT,Hb and RBC on the 1st and 7th postoperative day were significantly lower than preoperative day.Although the level of PLT decreased on the 1st postoperative day,it recovered on the 7th day.The markers of liver and renal function did not change during treat time.Packed red blood cells were collected during surgery with a mean value of 1 765 ml(300～6 000 ml) per patient.The average amount of allogenic transfusion per patient was 2 247ml(0～8000 ml).The perioperative mortality rate was 10.5%(2/19).The postoperative metastasis rate was 35.3%(6/17).No difference was found in the prognosis between two groups.Conclusion The intraoperative autologous blood salvage does not markedly change the clinic test data and not increase the recurrence and metastasis of renal cell carcinoma.

Objective To investigate the relationship of expression of cyclooxygenase-2(COX-2) and vascular endothelial growth factor(VEGF) with the growth pattern,malignant degree,metastasis and prognosis of gastrointestinal stromal tumor(GIST).Methods The expression of COX-2 and VEGF was examined with immunohistochemistry from paraffin-embedded tissue sections of 54 patients with GIST,and special attention was given to analyze the relationship between COX-2、VEGF expressions and clinicopathologic factors of the neoplasm.Results The expression of COX-2 and VEGF was significantly higher in malignant GIST than in benign and potentially malignant GIST(P

Objective:To study the effect of Shenqi Fuzheng injection combined with interferon-α (IFN-α) on the expression of STAT1 gene in hepatocellular carcinoma cells,and to elucidate its mechanism of IFN-α synergistic effect.Methords:The effect of IFN-α injection alone or combined with Shenqi Fuzheng injection on the proliferation of MHCC97-L cells was detected by MTT assay.IFN-α was detected by Real-time PCR and Western-blot respectively.The expression of STAT1 mRNA and protein in the experimental group,the negative control group (NaCl) and the blank control group were determined,and the effect of Shenqi Fuzheng injection on the transcription and expression of STAT1 was determined.The expression of STAT1 in lentiviral vector MTT assay was used to detect the effect of IFN-α alone or in combination with Shenqi Fuzheng injection on the STAT1 gene silencing cells.The expression of STAT1 was detected by RT-PCR and Western-Blot in MHCC97L cells.Strain,on cell proliferation.Results:Compared with IFN-α alone,Shenqi Fuzheng injection combined with IFN-α enhanced the inhibitory effect of IFN-α on MHCC97-L (P＜0.01) and up-regulated the expression of STAT1mRNA and protein (P＜0.05).Successfully constructed the STAT1 gene silent in the MHCC97-L cell line.There was no significant difference in the inhibition rate of MHCC97-L between Shenqi Fuzheng injection and IFN-α (P＞0.05).Conclusion Shenqi Fuzheng Injection can up-regulate the expression of STAT1 in human hepatocellular carcinoma cell line MHCC97-L,so as to increase the effect of IFN-α.

To develop an inquiry scale for diagnosis of heart system syndromes, and to discuss the provisional standardization of the inquiry method in traditional Chinese medicine (TCM).

Objective:To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) for adult severe tetanus by comparing the NLR in patients with severe and mild tetanus.Methods:A total of 65 adult tetanus patients from the Linyi Central Hospital from January 2009 to December 2020 were enrolled. The patients were divided into two groups including mild group and severe group according to the Ablett classification. The general conditions, laboratory data, and NLR of patients in two group were retrospectively compared using independent samples t test. Multivariate logistic regression analysis was used for the analysis of risk factors for severe tetanus. Spearman correlation method was used for the analysis of the correlation between risk factors and Ablett grades. Receiver operator characteristic (ROC) curve was used for the evaluation of the predictive value. Results:Among the 65 tetanus cases, 34 was in mild group and 31 in severe group. The latency period of patients in severe group was (7.00±3.19) d, which was shorter than that in mild group ((9.18±2.59) d), and the difference was statistically significant ( t=3.03, P=0.004). The NLR of patients in severe group was 4.251±1.936, which was higher than that of mild group (2.533±1.026) , and the difference was statistically significant ( t=4.41, P<0.001). Multivariate logistic regression analysis showed that NLR and latency period were independent risk factors for tetanus severity (odds ratio ( OR)=2.359, 95% confidence interval ( CI) 1.415 to 3.934, P=0.001 and OR=0.748, 95% CI 0.599 to 0.936, P=0.011, respectively). In tetanus patients, the NLR level was positively correlated with Ablett grade ( r=0.644, P<0.001). The ROC curve showed that NLR had good predictive value for adult severe tetanus at a cut-off value of 2.471 (area under the curve (AUC)=0.787), with the sensitivity and specificity of 87.1% and 61.8%, respectively. When combining NLR with latency period (cut-off value of 7.5 d), predictive efficiency was further improved (AUC=0.832) with the sensitivity of 87.1% and specificity of 67.6%( Z=3.43, P<0.001). Conclusions:NLR has a good predictive value for adult severe tetanus, and the predictive efficiency is further improved when combined with latency period.

Objective To analyze the risk factors of cerebral microbleeds (CMBs) in acute cerebral infarction patients. Methods We consecutively included 255 acute cerebral infarction patients who were admitted in Neurology Department of the First Affiliated Hospital of Fujian Medical University from January 2014 to December 2016. According to the number and location of CMBs, the patients were divided into infratentorial, cortical and deep cerebral groups, each of which included non-mild and moderate-severe subgroups. The differences of the level of glomerular filtration rate (eGFR) and some common arteriosclerotic risk factors were analyzed between subgroups, and the multiple logistic regression analysis was performed. Results A total of 140 subjects (54.9%) had CMBs. In the infratentorial group, the proportion of patients who were with low eGFR level in the moderate-severe CMBs subgroup was higher than in the non-mild CMBs subgroup (P=0.024). The low eGFR level (OR=3.874, 95% CI:1.261～11.901, P=0.018) and the long duration of hypertension (OR=2.128, 95%CI: 1.004～4.510, P=0.018) were the independent risk factors of the moderate-severe infratentorial CMBs. Conclusion The low eGFR level and long duration of hypertension are risk factors for the moderate and severe infratentorial CMBs after acute ischemic stroke.

Objective To summarize the phenotypic spectrum of cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) in Fujian population,evaluate the efficiency of the scale and try to adjust it.Methods Thirty-eight CADASIL patients and 64 CADASIL-like patients were recruited based on the CADASIL scale and gene tests,who visited the First Affiliated Hospital of Fujian Medical University and Fujian Neurology Research Institute from May 2011 to November 2017.Their clinical and neuroimaging characteristics were analyzed.Results The migraine,migraine with aura,transient ischemic attack / stroke,early onset age,psychiatric disturbances,cognitive decline,leukoencephalopathy,subcortical infarcts showed no statistically significant differences between the two groups.Instead,compared with CADASIL-like patients (10/64,15.6％;47/64,73.4％;10/64,15.6％),CADASIL patients demonstrated higher percentages of temporal pole involvements (13/38,34.2％;x5=4.716,P=0.030),external capsule involvements (36/38,94.7％;P=0.008) and family history in at least two generations (13/38,34.2％;x2=4.716,P=0.030).According to the scale,the scores showed statistically significant difference between CADASIL (14.84 ± 3.03) and CADASIL-like patients (13.34 ± 3.31;t=2.282,P=0.025) with an area under receiver operating characteristic curve of 0.622.Conclusions CADASIL showed no specific symptoms in Fujian population.The neuroimaging features were proposed to be focused on,especially the external capsule involvements.CADASIL scale could improve diagnostic efficiency,but still needs to be adjusted for Fujian population.The weight value of migraine,migraine with aura and cognitive decline was suggested to be decreased.

Objective To assess the prognosis and effect on renal function of pediatric urolithiasis caused by melamine-contaminated milk powder (PUMMP) in a long-term follow-up.Methods One hundred and two of 8335 children (≤ 6-year-old) with history of consuming melamine-contaminated milk powder screened in our hospital were followed up for eighteen months after diagnosis. Urinary system ultrasonography, urinalysis, urinary microprotein profiles [microalbumin (ALBU), immunoglobulin G (IgG), and N-acetyl-β-D-glucosidase (NAG)], urinary melamine and cyanuric acid were examined in the first visit and at the end of follow-up. Results Follow-up was completed in 91 children and the stone was excreted in 82 children (90.1%).Stones less than 5 mm in diameter were most vulnerable to discharge, and stones larger than 10 mm could not be expelled without interventions. At the end of follow-up, no melamine or cyanuric acid was found in the urine samples of 74 patients. Urinalysis showed that incidences of proteinuria, microscopic hematuria and leukocyturia were 0%, 5.1% and 2.0%, which were significant different from those in the first visit (Pproteinutria=0.123, Phemnatuna=0.038 and Pleukocyhuris=0.005).Urinary microprotein profiles revealed that some children whose urinalysis was normal still presented glomerular and renal tubular injury and the abnormal rates were 8.8% and 12.1%respectively. The glomerular injury was mainly related to persistent stone, male and younger.Conclusions 90.1% of children with PUMMP passes urinary stones at the end of follow-up.Stone size is the major risk factor of discharge. No melamine or cyanuric acid is found in the urine of children. After eighteen months, glomerular and renal tubular injury is still found in some patients. Further follow-up is necessary.