Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objective To investigate the safety,effectiveness and prognosis of percutaneous microwave ablation (MWA) combined with synchronous transarterial chemoembolization (TACE) to treat of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with liver metastases (LMs).Methods This retrospective study included 19 cases of GEP-NENs with LMs patients who received percutaneous MWA combined with synchronous TACE treatment from 2013 to 2016.The mRECIST standard was selected to assess the curative effect.SPSS 21.0 software was applied in the statistical analysis of overall survival (OS),progression-free survival (PFS) and factors related to prognosis.Results All patients were capable of curative effect evaluation,including 1 case of complete remission (CR),3 cases of partial remission (PR),7 cases of progressive disease (PD) and 8 cases of stable disease (SD) respectively accounting for 5 ％,16 ％,37 ％,42 ％,which exhibited 21％ of response rate (RR) and 63％ disease control rate (DCR).In the present study,the median OS and median PFS was respectively 25 months and 34 months,and the one-year survival and three-year survival was respectively 95％ and 84％.Serum CA199,the WHO classification of LMs and the tumor burden of LMs were the major risk factors of prognosis through single factor analysis of survival,which showed that G3 of the WHO classification of LMs predicted a poor OS (P＜0.05) and tumor burden of LMs was negatively related to PFS (P＜0.05).It was obviously observed that serum CgA was decreased by the therapy of percutaneous MWA with synchronous TACEfor GEP-NENs (P＜0.05).Conclusions Percutaneous MWA combined with synchronous TACE is a safe and effective method to treat GEP-NENs with LMs.

Objective:To study effects of neuroligin (NLG) on the proliferation and apoptosis in human neuroblastoma SH-SY5Y cells.Methods:The SH-SY5Y cells were cultured in vitro for 24 hours,and then transfected with NLG siRNA at dose of 50,100,200 μmol/L,respectively.MTT procedure was used to detect the cell proliferation,and expression levels of apoptosis gene including Bax or Bcl-2 and Bcl-xl were measured by RT-PCR.Results:Compared to control groups proliferation of SH-SY5Y cells were distinctly inhibited after NLG siRNA transfection accompany with a dose-dependent,which was caused by activation of apoptosis.Conclusions:NLG protect neuron by inhibiting apoptosis.

Interrupted aortic arch is a rare congenital vascular malformation associated with a high mortality rate in infancy, and is therefore very unusual in adults. We report a case of interrupted aortic arch in a 42-year-old male hypertensive patient who was found to have a disruption of aorta continuity distal to the left subclavian artery with massive collateral circulation into the descending aorta by computed tomography angiography. The patient was discharged after the blood pressure was controlled by antihypertensive therapy. This case suggests the necessity of careful auscultation for young patients with hypertension. Once murmur in the chest and back is heard, computed tomography angiography should be performed at once to avoid missed diagnosis and misdiagnosis.
Adult ; Aorta, Thoracic ; pathology ; Aortic Diseases ; complications ; Humans ; Hypertension ; etiology ; Male

OBJECTIVETo examine the expression of nucleotide-binding oligomerization domain 1 (NOD1), nuclear factor-kappa B (NF-κB) and human beta-defensins in candidal albicans leukoplakia and to investigate the effect of candida albicans infection on key proteins in NOD1 signaling pathway and the expression of human beta-defensin.

METHODSForty cases of oral leukoplakia samples were collected and stained by hematoxylin-eosin staining, periodic acid-Schiff staining, silver staining and immunohistochemical methods. Nineteen samples were positive with these four methods and judged as candidal albicans leukoplakia, and the other twenty- one samples judged as leukoplakia without candidal albicans infection. Western blotting was used to detect the expressions of NOD1 and NF-κB in these forty samples. In addition, the immunohistochemical method was adopted to investigate the relationship between NOD1, NF-κB, human beta-defensin 1, 2, 3 expressions and candida albicans.

RESULTSThe positive rate of candida albicans in oral leukoplakia was 48% (19/40). The expressions of NOD1 and NF-κB in the candida albicans leukoplakia were lower than that in leukoplakia without candida albicans infection. The mean optical density value of NOD1, NF-κB, human beta-defensin 1, 2, 3 in candidal albicans leukoplakia were 0.25 ± 0.01, 0.30 ± 0.02, 0.35 ± 0.02, 0.42 ± 0.03, 0.36 ± 0.02 respectively, which were significantly lower than that in leukoplakia without candida albicans infection (0.31 ± 0.02, 0.47 ± 0.03, 0.42 ± 0.02, 0.53 ± 0.04, 0.47 ± 0.03) (P < 0.05).

CONCLUSIONSBy inhibiting the NOD1 signaling pathway, candida albicans infection may reduce the expression level of human beta-defensin 1, 2, 3 in oral leukoplakia.

Blotting, Western ; Candida albicans ; Candidiasis ; metabolism ; Humans ; Leukoplakia, Oral ; metabolism ; NF-kappa B ; biosynthesis ; Nod1 Signaling Adaptor Protein ; biosynthesis ; Nucleotides ; Signal Transduction ; beta-Defensins ; biosynthesis

Pancreatic malignant tumor with more complex diagnosis and treatment is one of digestive system tmnors,especially pancreatic cancer (PC) continues to have high malignancy and poor curative effect and prognosis."Pancreas" conference is currently held every.two years,and it is acknowledgedas a distinguished gathering of the pancreatic tumor field through showing abundant leading-edge achievements.Authors summarized contents and features of the Pancreas 2018 conference sponsored by Johns Hopkins Hospital,and made some analyses based on translational medicine,evidence-based medicine,multidisciplinary team,new surgical technology and domestic teams' harvests,meanwhile,they also will disseminate and share leading-edge information with domestic doctors,and provide new ideas for diagnosis and treatment of PC and basic and clinical researches.

Objective: To investigate the effect of emergency thoracic endovascular aortic repair (TEVAR) in patients with acute traumatic thoracic aortic injury. Method: From January 2014 to December 2016, a total of 35 patients with acute traumatic thoracic aortic injuries were treated with emergency TEVAR in our hospital, their clinical data were analyzed retrospectively in this study. Results: The patients were 42 (34, 55) years old,and there were 31 males.All cases were diagnosed by emergency aorta computed tomography angiography (CTA),and 5 cases were diagnosed as aortic transaction, 13 cases were diagnosed as aortic pseudoaneurysm, 7 cases were diagnosed as aortic dissection, and 10 cases were diagnosed as aortic intramural hematoma combined hemothorax.The concomitant injuries included cerebral contusion (3 cases, 8.6%), pulmonary contusion with rib fracture (31 cases, 88.5%), long bone fracture (7 cases, 22.5%), contusion of viscera or internal organs (3 cases, 8.6%).Emergency TEVAR were performed with vascular suture system preset under local anesthesia after diagnosis,and combined injury was treated in related departments.CTA was repeated after 1, 3 and 6 months and yearly thereafter. One patient died before transferring to catheter room,and 34 (97.1%) patients underwent TEVAR procedure successfully.Time from door to operating room was (88.6±26.6) minutes,and the procedure time was (52.0±9.4) minutes. A total of 69 Perclose Proglide vascular suture system were used,and 2 cases underwent surgical suture because of hematoma and pseudoaneurysm formation in femoral arteries.The involved length of thoracic aorta was (44.5±7.4)mm. A total of 46 stent-grafts were implanted, the length of stent-graft was (164.3±15.2)mm,and the proximal oversize rate was (22.3±8.6)%. The follow-up time was 24 (12,24) months, and there were no procedure related complication such as endoleak and paraplegia. Complete aortic remodeling was observed in 14 cases. Fully thrombolization at stent segments were observed in 7 cases. Fully thrombalization of pseudoaneurysms were observed in 13 cases. One patient complained mild left upper limb weakness due to left subclavian artery occlusion. Conclusion Emergency TEVAR is safe and effective procedure for the treatment of patients with acute traumatic thoracic aortic injury.

Objective:To establish a model of improving diagnostic capability in infiltration depth of colorectal cancer (CRC) with combining narrow band imaging system(NBI) and endoscopic ultrasonography (EUS).Methods:CRC patients who were treated in Chongqing Fifth People′s Hospital from April 2015 to March 2021 were selected retrospectively as the research objects. All patients were diagnosed by postoperative pathological diagnosis. In the end, a total of 288 CRC patients were included. Using the random number table method, the study subjects were divided into modeling group ( n=192) and verification group ( n=96) at a ratio of 2∶1. The patients′ general information, NBI and EUS examination results were collected; logistic regression was used to analyze the independent risk factors of CRC submucosal infiltration, and a model was built to predict the depth of CRC infiltration; receiver operating characteristic (ROC) was used to identify the diagnostic ability of model. The diagnostic efficacy of CRC submucosal infiltration was verified internally by the verification group. Results:In the modeling group, lymph node metastasis ( OR=6.492, 95% CI: 5.128-7.855, P<0.001), low tumor differentiation ( OR=2.736, 95% CI: 1.731-3.741, P<0.001) and tumor length ( OR=2.049, 95% CI: 1.524-2.574, P<0.001) were independent risk factors for submucosal infiltration in CRC patients; The nomograph model constructed according to the above independent risk factors had a strong diagnostic ability for the depth of submucosal infiltration of CRC, and was internally validated in the validation group. AUC values of the modeling group and the validation group were 0.945 (0.935-0.955) and 0.951 (0.942-0.961), respectively. Conclusions:The nomogram model established by the combination of endoscopic narrow band imaging technology and ultrasound endoscopy can diagnose the depth of CRC infiltration better.

ObjectiveTo assess the effectiveness of tele-medicine and self-management goal(SMG) setting technique used in the diabetes management in the community setting.Methods It is a control-group study.415 type 2 diabetic residents were recruited from the Shanghai Wuliqiao community based on existing medical records.The subjects were divided into two groups,the study group was cared by general practitioners (GPs) specialists cooperation through the tele-medicine mechanism,the other was a control group.For the study group,a cooperation pathway between community health care centers and general hospitals were established.Standardized training and guidelines were provided to community health workers,regarding the setting of management goals of blood glucose and blood pressure,treatment plan,patient education,and SMG techniques.Fasting blood glucose ( FBG ) and 2 h postprandial blood glucose (2hBG) in the study group were monitored,followed by community health workers visiting monthly with seminars for diabetes education.At the baseline and the 12tb month,FBG,2hBG,HbA1C,blood pressure,triglyceride,total cholesterol,body mass index,waist-hip ratio were determined in each group.A survey was conducted to evaluate the costs of diabetes treatments,the knowledge base related to their disease,lifestyle,and the awareness of the new care model.The rates of achieving the goal of blood glucose,blood pressure,and HbA1Ccontrol were calculated.Internet case discussion between GPs-Specialists and referral to certain specialists were implemented when some patients did not reach the control goal.ResultsBy the 12 month follow up,FBG,2hBG,HbAIc,blood pressure of the study group were lower than the baseline,and as well as the control group with statical significance (P＜0.05).There are other improvcments:diabetes knowledge (29.1％ vs 5.5％ ),healthy diet (9.6％ vs -10.4％ ),blood glucose monitoring (30.3％ vs 10.8％ ),support for diabetes care in community (35.7％ vs 9.4％ ),and the preference of the new model (63.8％ vs 17.9％ ) with statistical significauce (P＜0.01 ).As for the medical costs,the study group's monthly costs were consistently lower than the control's.( -3.39Yuan vs 32.26 Yuan,P＜0.05).ConclusionsThe new diabetes care model based on GPs-Specialists tele-medicine and SMG in community opens the door to the community based care model formulation in regard to the health quality and costs control.The deployment of more technologies and management techniques could be explored further to improve the outcomes of community based chronic disease care model.

Objective To analyze the difference among the 3 guidehnes used to make surgical decision for branch duct intraductal papillary mucinous neoplasm (BD-IPMN),then the guidelines were combined with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) respectively for further analysis.Methods Clinical data of 51 appropriate BD-IPMN patients who underwent surgical resection from January 2008 to December 2015 was retrospectively analyzed.Results The significant difference was exist in the consensus for followup criterion (P ＜ 0.05).The preoperative NLR and PLR were helpful for the differential diagnosis between malignant and benign BD-IPMN,because the receiver operating characteristic curve (ROC) of NLR and PLR for prediction were 0.686 and 0.692,and the best boundary values were 2.64,92.56 respectively.The consensus combined with PLR could improve the specificity and positive predictive value (PPV),besides,the specificity and PPV could achieve 70.3％,54.2％ respectively while the sensitivity (92.9％) still remained at an ideal level after international consensus guideline combined with PLR.Conclusions NLR ≥ 2.64 and PLR ≥ 92.56 were predictive markers for the presence of BD-IPMN associated invasive tumor.The addition of PLR as a criterion to the international consensus guideline improved the accuracy of international consensus guidelines in estimating invasive BD-IPMN.