80 years)in China is increasing.As a special type of hypertension,the hypertension in the very elderly has some specificities in pathogenesis,clinical manifestation,treatment and prognosis.The topic to effectively cure and prevent hypertension in the very elderly is increasingly emphasiced.This article presents an overview of recent progress in clinical characteristics,and treatment strategy related to hypertension in the very elderly.

Objective:To investigate the clinical value of magnetic resonance imaging (MRI) in differential diagnosis for benign and malignant lesions of solitary pulmonary nodules (SPN).Methods: 120 patients with SPN were enrolled in the retrospective analysis, and all of them underwent scan of MR including MRI, DCE-MR and diffusion weighted imaging (DWI) before their surgery. All of patients received detection of pathology or histopathological examination after their surgery, and the ADC values under different b values of dispersion sensitivity factor (300 s/mm2, 500 s/mm2 and 800 s/mm2) were compared.Results:Under the conditions both of 300 s/mm2 and 800 s/mm2, the differences of ADC value between benign nodule and malignant nodule were not statistically significant (t=1.195,P>0.05). And under the condition of 500 s/mm2, the ADC value of benign nodule was significantly higher than that of malignant nodule (t=4.313,P<0.05), and at this time, the sensitivity, specificity, rate of missed diagnosis and misdiagnosis rate of the differential diagnosis for benign and malignant lesions of SPN by using MR were 85.71％, 74％, 14.9％ and 26％, respectively.Conclusion: MR examination has higher sensitivity in differential diagnosis for benign and malignant lesions of SPN, and it has a certain clinical value when it is used as early detecting method.

OBJECTIVE To investigate the drug-resistant genes associated ?-lactams in Pseudomonas aeruginosa(isolated) in Shaoxing,Zhejiang Province.METHODS Thirty nine strains of P.aeruginosa were isolated from(hospitalized) patients,and drug-resistant genes were detected by PCR.RESULTS The positive rates of genes of TEM, CARB,VIM and DHA were 2.6%,30.8%,23%,and 7.7%,respectively,oprD2 gene was all lack.Genes of SHV,OXA-1 groups,OXA-10 groups,PER,VEB,GES,IMP,SPM and GIM were not found in all 39 isolates tested.CONCLUSIONS There are very high positive percentages of CARB and VIM genes in P.aeruginosa(isolated) clinically.The oprD2 gene lack is the important mechanism of P.aeruginosa resistant to(imipenem.) The CARB genes in P.aeruginosa are firsted report domestically.

OBJECTIVE To know the antibacterial activity of cefotaxime/sulbactam against 4 kinds of Gram- negative bacilli in vitro in general clinics. METHODS By double-disk test to detect the ESBLs of Escherichia coli and Klebsiella pneumoniae and the metallo-?-lactamase of Pseudomonas aeruginosa and Acinetobacter baumannii. And all the tested bacilli were tested by 14 kinds of general antibacterial drugs through K-B experiment. RESULTS Fifty one of 164 Enterobacteriaceae strains were ESBLs positive, including 23 E. coli strains with positive rate of 26.3% and 28 K. pneumoniae strains with positive rate of 35.9%. The metallo-?-lactamase was produced in 33 of 85 P. aeruginosa strains and the positive rate was 38.8%, and none in A. baumannii. The result showed cefotaxime /sulbactam was very sensitive to Enterobacteriaceae, no matter it had enzyme or not. These drugs had a special high sensitivity to ESBLs producing E. coli and K. pneumoniae, and their sensitivity rate was 87.0% and 89.3%. The sensitivity rate to P. aeruginosa, produced enzyme or not was 56.7% and 92.3%. CONCLUSIONS Cefotaxime/sulbactam has a powerful antibacterial activity against 4 kinds of Gram-negative bacilli in vitro in general clinics, especially to the infection caused by ESBLs-producing or metallo-?-lactamase-producing bacteria, and can be taken as the preferred drugs.

Objective To analyze the human cellular repressor of E1A-stimulated genes (hCREG)using bioinformatics tools and predict the promoter position and transciption factor binding sites.Methods Complete coding hCREG sequences were obtained from Genbank.hCREG was analyzed with First EF software in order to obtain the promoter sequence of hCREG.Moreover,transcription factor binding sites of hCREG was convinced by Motif software.Subsequently,the transcription factor of hCREG by bioinformatics tools was related between hCREG and smooth muscle cells differentiation observed by both Western blot and immunoflourescence.Results The promoter of hCREG was located in -109~-359 bp of up-stream of transcriptional site,which was predicted with 945bp length.Transciption factor binding sites of hCREG was predicted by Motif software which was found with 80 transciption factors.The expression of hCREG and smooth muscle ?-actin(SM ?-actin)increased in HITASY after 72 hours with serum deprivation detected by both Western blot and immunoflourescence.Meanwhile,the results showed that the expression of wtp53 increased significantly.These results suggested that transcription factor wtp53 might regulate the expression of hCREG and promoted dedifferentiated phenotype of VSMCs.Conclusion The transcriptional information of the proximal promoter of hCREG obtained.As up-stream regulational factor of hCREG,wtp53 can up-regulate the expression of hCREG and may play a vital role in the process of VSMCs differentiation and phenotype modulation.

Vasovagal reflex is one of complications from cardiac intervention.The major causes of vasovagal reflex postprocedure are commonly believed to be associated with mental stress,pain,low blood volume,visceral dilation,local hematoma and cardiac function.The incidence of vasovagal reflex may be effectively reduced with standard intervention training,strictly selected indications for PCI,adequate fluid replacement after procedure,anesthetic lidocaine to reduce pain,improved manual compression for vascular hemostasis and elimination of risk factors.

Objective To investigarte the immune status in the patients with dengue fever .Methods The flow cytometry was used to detect the T lymphocytes in the patients with dengue fever for analyzing their immune status .Results Compared with the reference range in the healthy individuals ,it was found that the T lymphocyte proportion in the patients with dengue fever was sig‐nificantly reduced compared with the healthy individuals .The percentages of CD3+CD4+ and CD3+CD8+ lymphocytes were (36 .54 ± 9 .78)% and (17 .7 ± 10 .01)% respectively ,which had statistical difference compared with the control group(P<0 .05) ,CD3+CD4+ lymphocyte count was (49 .98 ± 240 .2)cells/μL ,the difference was statistically significant (P<0 .05) ,CD3+ CD8+ lympho‐cytes count was (380 .9 ± 364 .6)cells/μL ,the difference was statistically significant(P<0 .05) .Conclusion The immune status in the patients with dengue fever is abnormal ,T lymphocyte percentage is significantly reduced compared with the healthy individuals .

Objective To investigate relationship between microRNA-200c and ZEB1 in cervical epithelial mesenchymal transition factor. Methods 50 cases diagnosed with cervical cancer whose tumor tissue were taken to be the experiment group.50 cases diagnosed with uterine myoma whose normal tissue were taken to be the control group.ZEB1 and microRNA-200c of uterine tissue were were detected.Results The average level of ZEB1 in the experimental group was significantly higher than that of the control group (P<0.05), and in cervical cancer, lymph node metastasis and the depth of myometrial invasion had statistically significant (P<0.05).In experimental group, microRNA-200c average was lower than control group (P<0.05), and in cervical cancer, different pathological grade group, lymph node metastasis and deep muscular layer infiltration had statistically significant(P<0.05).In experimental group, ZEB1 and microRNA-200c showed negative correlation(r =-0.270 P =0.001).Conclusion The expression level of ZEB1 in cervical cancer is higher, and the expression level of microRNA-200c in cervical cancer is lower, suggesting that the two factors may play an important role in the invasion and metastasis of cervical cancer.The correlation between the two factors suggests that microRNA-200c may be involved in the process of cervical cancer by ZEB1.

Objective To explore the effect of Lee Silverman voice treatment on the speech and life quality of Parkinson's disease patients.Methods A total of 98 patients with Parkinson's disease anddifferent degrees of speech disorder (Hoehn-Yahr clinical stages 1 to 3) were randomly divided into an intervention group and a control group,each of 49,according to a random number table.The control group was given routine speech therapy covering tongue and lip movement,rhythm,sound,volume,speed and respiratory control.The intervention group was provided with 12 weeks of Lee Silverman voice treatment aimed at abnormal voice and emphasizing pronunciation,4 times a week and 1 hour each time.During the treatment,all patients were required to practice once at home on treatment days and twice on days without treatment.The voice handicap index (VHI),the western aphasia battery (WAB),the speech function portion of UPDRS-Ⅲ and the speech articulation assesstnent were used to evaluate the 2 groups before and after the 12 weeks ofintervention.Results Beforethe intervention there was no significant differencebetween the two groups in any of the measurements.After the interventionsignificant improvement was ohserved in all of these indicesin bothgroups.After treatment the average total VHI score of the intervention group (60.39±9.84) had improved significantly more than that of the control group,as did the WAB score for spontaneous speech (14.64±1.98),listening comprehension (112.67± 19.43),repeating (65.31±7.98),Name (39.89±9.84) and the average AQ scores (69.19±10.78) and UPDRS-scores [(1.39±0.61)] [of the intervention group than the control group [(71.03±11.01),(13.67±1.06),(111.53±29.61),(63.75±7.41),(37.89± 9.29),(62.14±10.21) and (1.82±0.82)].After the intervention,the average speech articulation scores of the intervention and control group were (77.61± 11.72) and (59.67± 10.04),significantly higher than those before the intervention [(54.36±10.71) and (53.98±9.92)],with the improveinent of the intervention group significantly higher than the control group.Conclusion Lee Silverman voice treatment can effectively improve the speech and life quality of patients with Parkinson's disease.

Key factors for interpreting proficiency testing (PT)/external quality assessment (EQA) results are knowledge of the commutability of the samples used and the process used for target value assignment.A commutable PT/EQA sample,which would be seen as patients' samples,has the agreement of results among different measurement procedures and demonstrates the same numeric relationship.The value assignment for the sample can be done by using of a reference measurement procedure.Its results can be used to assess the accuracy against a reference measurement procedure or a designated comparison method.Noncommutable PT/EQA samples frequently have a matrix-related bias of unknown magnitude,and can't give meaningful information about the relationship of results for patients' samples among different measurement procedures.Its results must be compared to the peer group mean or the median of results from participants who use measurement procedures that are expected to have the same or very similar matrixrelated bias.