The status of health care for elderly in 110 community health service (CHS) centers of Bao'an District was surveyed.Data were collected from directors,health care managers and health workers in CHS centers by questionnaire.The results showed that the establishment of health file was satisfactory.but the management of health file needed to be strengthened,particularly for those required special care.The nutritional and psychological counseling should be specially focused.

Objective:To observe the levels of serum endothelin(ET),nitric oxide(NO),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in prehypertension and hypertension patients.Methods:Three groups were recruited from 3050 subjects of regular health checkup in Tangshan Railway Hospital from June to September,2007. Prehypertension (PH) group: n=106,Essential hypertension (EH) group: n=91,and Normotensive (NT) control group: n=98.The levels of ET,TNF-α,IL-6 and NO were compared by radioimmunoassay and biochemical tests. Results: ①Compared with NT group,body mass index (BMI) and serum lipids (TC,TG,LDL-C) were significantly increased in PH and EH groups (P<0.05),high-density lipoprotein cholesterol (HDL-C)was decreased in EH groups (1.59±0.15 vs. 1.77±0.19,P<0.05). ②Compared with NT group,ET,IL-6,TNF-α were increased in PH and EH groups (P<0.05).NO was increased in PH group (6.55±0.94 vs. 5.87±0.80,P<0.05) while decreased in EH group (5.28±0.81 vs. 5.87±0.80,P<0.05). ③Logistic analysis indicated that BMI,ET,NO,TNF-α and IL-6 were related to the hypertension. Conclusion: ET,NO,TNF-α,IL-6 were elevated in prehypertension patients and those might be used to predict the risk of hypertension.

ObjectiveTo study the effect and safety of flurbiprofen cataplasm on osteoarthritis pain in Chinese patients.MethodsOne hundred and eighty-three patients were divided into flurbiprofen cataplasm group,indometacin cataplasm group and Qizheng-xiaotong plaster group randomly.The score of pain,stiffness and physical function were analyzed with WOMAC scale and adverse reactions were also assessed.KruskalWallis H test,Nemenyi test and CMH tese were used.ResultsAfter treatment,the VAS value of the three groups decreased significantly and the VAS difference value of the flurbiprofen cataplasm group changed the most significantly(the changes of VAS value in flat walking,up and down stairs,nighttime,rest and weightbearing were 31±21,35±20,24±19,20±18 and 37±20 respectively).Meanwhile,the value of stiffness and physical function decreased significantly.In terms of safety,flurbiprofen cataplasm group and the indome-tacin cataplasm group were better than Qizheng-xiaotong plaster group.But in sense of constriction,the flurbiprofen cataplasm group was better than the indometacin eataplasm group.ConclusionFlurbiprofen Cataplasm,with its favorable analgesic effect,is suitable for general clinical use.It can reduce stiffness,improvephysical function,and has good safety profile.

OBJECTIVE:To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia(SAP). METHODS:A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group(42 cases)and observation group (42 cases)according to random number table. Based on routine treatment,control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5% Glucose injection 100 mL,intravenously,twice a day;suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed,and the levels of T-lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and inflammatory markers(TNF-α,hs-CRP,PCT),length of hospital stay before and after treatment. The ADR was recorded. RESULTS:The total response rate(95.24%)and marked response rate (47.62%)of observation group were significantly higher than those of control group(83.33%,23.81%);length of hospital stay in observation group [(15.24±3.53)d] was significantly shorter than control group [(18.43±4.21)d],with statistical significance (P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of CD8 +,TNF-α,hs-CRP and PCT in 2 groups were significantly lower than before treatment;the observation group was significantly lower than the control group,with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly,can effectively improve immune function, reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.

Objective To evaluate the efficacy and safety of modified transurethral plasmakinetic enucleation of prostate (M-TPEP) combined with cystolithectomy in elderly patients with high risk of large volume benign prostatic hyperplasia (BPH) complicated with large urinary bladder calculi. Methods Seventy-one patients with high risk of large volume BPH complicated with large urinary bladder calculi were selected, and the patients were treated with M-TPEP combined with cystolithectomy. The operation time, intraoperative blood loss, hospitalization time, complications, and the maximum urinary flow rate (Qmax), post-void residual volume (PVR), serum potassium, international prostate symptom score (IPSS), quality of life (QOL) score preoperative and postoperative 3 months were recorded. Results Seventy-one patients successfully completed the operation, and no death occurred. The operation time was (75.48 ± 6.51) min, intraoperative blood loss was (82.63 ± 10.08) ml, and postoperative hospitalization time was 5-7 d. Incidence of intraoperative capsule perforation was 2.82% (2/71), incidence of postoperative temporary urinary incontinence was 7.04% (5/71), incidence of urethral and bladder irritation after operation was 8.45% (6/71), and incidence of postoperative wound infection was 2.82% (2/71). The PVR, IPSS and QOL score 3 months after operation were significantly lower than those before operation: (6.89 ± 0.74) ml vs. (205.13 ± 40.08) ml, (2.71 ± 0.45) scores vs. (28.62 ± 3.57) scores and (1.36 ± 0.24) scores vs. (4.93 ± 0.38) scores, the Qmaxwas significantly higher than that before operation: (22.46 ± 2.97) ml/s vs. (5.24 ± 0.43) ml/s, and there were statistical differences (P＜0.01);there was no statistical difference in serum potassium between before operation and 3 months after operation (P＞0.05). Conclusions M-TPEP combined with cystolithectomy has short operation time, quick recovery after operation and low complication rate. It is a proper operative method for the elderly patients with high risk of large volume BPH and large urinary bladder calculi.

Objective Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus is a rare morphological variant of endometrioid carcinoma.The biphasic morphological features may cause confusion with carcinosarcoma of the uterus,leading to misdiagnosis.The aim of this article is to elucidate the clinicopathological characteristics of such endometrial carcinoma to avoid misdiagnosis.Methods The clinical and pathological data of 5 cases of endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus were collected and analyzed.Results The age of the 5 patients ranged from 29 to 39 years,with a mean age of 33 years.Four patients underwent surgery of radical hysterectomy,the other dilation and curettage biopsy.Among the former,3 patients were at FIGO stage Ⅰ A,the other Ⅲ C1.Microscopically,all 5 tumors contained endometrioid carcinoma components,4 of which were FIGO grade Ⅰ,the remaining one was grade Ⅱ.Each tumor was of variable proportions of corded and hyalinized areas ranging from 10％ to 60％.The cells in the corded and hyalinized areas were epithelioid,fusiform and spindle in morphology,admixed with the endometrioid carcinoma component,resulting in a biphasic pattern.The corded and hyalinized component exhibited distinctively different immunophenotypical feature from that by the conventional endometrioid carcinoma component.The results of follow-up for 4 patients of 7 to 68 months (mean =26.5 months) revealed that all patients were alive without recurrence of the malignancy.Conclusions Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus presents unique morphology,and the patients are usually young with relatively favorable prognosis.The definite mechanism for the pathogenesis of the sex cord-like formations and hyalinization needs further investigation.

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.

Objective: To investigate androgen receptor(AR)expression in invasive breast carcinoma and the correlation with surrogate molecular breast carcinoma subtypes. Methods: Immunohistochemical staining of AR and other biomarkers was performed in a cohort of 870 cases of primary invasive breast carcinomas collected from August to December, 2016. The association of AR expression with different histological and surrogate molecular subtypes was analyzed. Results: The positive expression rate of AR in the immunohistochemistry-based surrogate subtypes was 96.3%(207/215) for Luminal A, 89.8%(378/421) for Luminal B, 82.4%(75/91) for HER2 overexpression and 37.1%(53/143) for triple negative breast carcinoma, with significant differences among the four groups (P<0.01). AR correlated positively with the expression of ER(P<0.01), PR(P<0.01), HER2(P=0.007), GATA3(P<0.01), GCDFP15(P<0.01)and mammaglobin(P<0.01), while negatively with the expression of Ki-67(P<0.01), CK5/6(P<0.01)and CK14(P<0.01). Conclusions AR exhibits a high expression in invasive breast carcinoma, which is mainly correlated with ER-positive breast carcinoma. Regardless of the relatively low expression rate, AR is a potential therapeutic target in triple negative breast carcinoma.

Chimeric antigen receptor modified T (CAR-T) cell, a novel adoptive immunotherapy strategy, has been used successfully against hematological tumors. However, in solid tumors, due to multiple immunosuppressive cells, immunosuppressive molecules, and extracellular matrix play a suppressive role in the cytotoxic effects of migrating CAR-T cells and severely inhibit the antitumor efficacy of CAR-T cells in the tumor microenvironment of solid tumors. Simultaneously, tumor heterogeneity, lacking proper tumor antigens, poor homing ability at solid tumor sites, along with off-target effect, resulting in poor therapeutic effect of CAR-T cells in solid tumors. Compared with hematological tumors, solid tumors have complex biological characteristics, and thus targeted strategies are demanded to ensure long-term efficacy of CAR-T cells against tumors. This review makes a summary of the development of CAR-T cells, the confusion in solid tumors and the progress of treatment strategies.

Objective To elucidate the clinicopathologic characteristics, immunophenotype and differential diagnosis of ovarian seromucinous carcinoma.Methods The clinical and pathological characteristics of 7 cases of ovarian seromucinous carcinoma were analyzed.Immunohistochemical study of selected markers was performed employing the EnVision method.Literature of ovarian seromucinous carcinoma were also reviewed.Results The age of the 7 ovarian seromucinous carcinoma patients ranged from 27 to 70 years of age ( mean=48 years).Two patients had bilateral ovarian tumors.The complaint of most patients was abdominal distention.The serum concentration of CA125 and/or CA19-9 was elevated in most patients.Four patients were found to have ascites during surgery, of whom 2 were also found to have malignant cells in their ascites or peritoneal washings.The maximum dimension of these tumors ranged from 6.0 to 15.0 cm ( mean=9.3 cm).Grossly, 6 of 9 tumors were predominantly cystic with protrusions of papillae from the inside wall of the cysts.Among these 6 tumors, 2 had brown viscous material in the cyst.The other 3 tumors were predominantly solid.Microscopically, all 9 tumors contained endocervical-like mucinous cells and other Mullerian cells.The tumor cells had intermediate or severe atypia.A lot of acute inflammatory cells especially neutrophil polymorphs could be seen in the stroma and lumens of all the 9 tumors, which is an apparent feature for ovarian seromucinous tumors.Architecturally, the tumors mainly exhibited complex papillary architectures, compactly back-to-back glandular lumensforming cribriform, labyrinthine formations, or solid growth pattern, with immunophenotype of Mullerian tumors.Mucin stain was performed in 1 tumor with AB positive, PAS positive and D-PAS positive, highlighting intracytoplasmicmucin secretions.Follow-up (3-86 months with a mean of 21 month) data revealed that except 1 patient dying of the tumor at 81 months after surgery, the other 6 patients all survived the malignancy. Conclusions Seromucinous carcinoma of the ovary possesses relatively special clinicopathologic features, with some morphological and immunophenotypical overlap with endometrioid carcinoma and low grade serous carcinoma of the ovary.It is necessary to thoroughly investigate the pathogenesis and molecular changes involved in the type of tumor to determine whether it is a convincingly distinctive category of ovarian carcinoma.