Objective To know the characteristics and tendency of unexpective death in the elderly of Shanghai downtown area. Methods The data of the elderly unexpective death in Jingan District were divided into 4 groups. The causes and frequency of unexpective death were analyzed. Results The average rate of unexpective death in the elderly of Jingan District were from 208/ 100 000 per year in 1986～1990 to 11/ 100 000 per year in 2001～2003.It descended about half.Fall and suicide death rate descended about half as well. Since 1986, there was no descent tendency for traffic accident and poisoning death. Conclusions Unexpective death in elderly is preventable and needs to pay much concern by relative departments.

Objective To determine the urine lead level in school_age children under conditions of environmental lead exposure and evaluate the effects of the presence of body lead on IQ, academic achievement and behavior in school of these children. Methods The concentrations of urine lead and IQs for 118 children aged 7～12 were measured. The academic achievement, behavior in school and the correlated factors were derived from the questionnaires given to their teachers and parents. Results The urine lead level of 118 children was (7.04?3.53)?g/L. In children who lived in city central area the urine lead level was (7.71?3.52)?g/L. It was significantly higher than that of children who lived in a suburban area [(6.37?3.45)?g/L]; No significant differences were observed in IQ between children in city and suburbs. The results by single factor analysis showed that the urine lead level [(10.31?2.16)?g/L] in the lower IQ group (IQ

Objective To investigate teaching situation of Introduction to Medicine at SJTUSM,and to make more progress in educational reforms. Methods By analyzing questionnaire and test paper,the relevant information was collected and analyzed by SPSS statistics software. Results Teaching the course at SJTUSM was basically satisfactory. Conclusion The investigation showed that the teaching quality of the course is being improved. However,the quality guarantee system of teaching process needs to be further perfected.

Objective To evaluate the regional cardiac function for patients with coronary heart disease (CHD) with multiple tissue Doppler imaging (TDI) parameters in rest state and to discuss the value of regional cardiac function in diagnosing CHD.Methods Forty-seven patients with chief complain of chest pain underwent TDI examination.Maximum systolic velocity (Sm),maximum early diastolic velocity (Em),maximum late diastolic velocity (Am),isovoluminal contraction time (IVCT) and isovoluminal relaxation time(IVRT) of 16 segments of left ventricle were measured.All the patients underwent coronary angiography (CAG) at the same time.CHD was diagnosed by at least one coronary artery with no less than fifty percent diametric stenosis.Segments dominated by coronary artery with fifty to ninety and more than ninety percent diametric stenosis were defined as moderate and severe lesion segments respectively.Others were non-lesion segments.Results There was no significant difference of sex,age,heart rate,CHD risk factors,left ventricular ejection fraction (LVEF) and E/A among non-CHD (13 cases),one-lesion(11 cases),two-lesion (11 cases) and three-lesion (12 cases)(P ＞0.05).Compared with those in non-lesion segments (390sections),Sm,Em and Em/Am decreased and IVRT prolonged in both moderate lesion segments (162 sections) and severe lesion segments (144 sections) (P ＜ 0.01).IVCT prolonged only in severe lesion segments (P ＜0.05),but not in moderate lesion segments.If setting a criterion that no less than three segments with Sm ＜ 2.50 cm/s and IVRT ＞ 87 ms was for CHD diagnosis,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 79.4％ (27/34),84.6％ (11/13),93.1％ (27/29),61.1％(11/18) and 80.9％(38/47).Conclusions In rest state,regional cardiac function of lesion segments in CHD patients shows changes of decreased systolic and diastolic velocity and prolonged isovoluminal time.Analyzing segmental cardiac velocity and time comprehensively may help to diagnose CHD.

Objective To evaluate the clinical and pathological characteristics and risk factors of the prognosis of Cardia cancer.Methods Clinical data of 52 cases of cardiac cancer patients who were treated by surgery and follow-up data were collected from June 2009 to August 2011.Factors influencing the prognosis of the patients were analyzed by univariate and multivariate analysis.Results The survival rates in 1,2,3years were 73％,54％,46％.Single factor analysis showed that there was a significant correlation between T stage,N stage,TNM stage,classification Siewert,MSLN and venous invasion.Stepwise Cox proportional hazard model showed that T stage,N stage and MSLN were independent risk factors.Peritoneal and liver were the main way of recurrence and metastasis.Peritoneal metastasis was related to T stage and lymph node invasion,while the liver metastasis was related to MSLN.The survival curves of patients with Kaplan-Meier showed that the survival period of patients with liver metastasis and peritoneal metastasis was significantly shortened.Conclusion Standardization of lymph node cleaning is a key factor affecting prognosis,D2 surgery should be an operation standard in cardia cancer.

Objective To evaluate the coronary lesions with two-dimensional strain echocardiography. Methods Sixty-seven patients with suspected coronary heart diseases who underwent coronary angiography were divided into two groups. Forty-two of them with coronary stenosis ≥70% were considered as patient group, and the other 25 with coronary stenosis ＜50% were regarded as control group. Two-dimensional strain was performed in all patients within 24 h before coronary angiography. Longitudinal systolic strain rate (SRs), early (SRe) and late (SRa) diastolic strain rate, systolic strain (Ss), and time to SRe (T-SRe) were measured and compared. Results Ss, SRs, SRe and SRe/SRa decreased significantly in regions controlled by coronary artery with ≥70% stenosis in patient group compared with those controlled by coronary artery with ＜50% stenosis in control group. SRs and SRe were the independent predictive factors of coronary stenosis ≥70%, and the sensitivity and specificity of SRe ＜0.91 to identify coronary stenosis ≥70% was 72.46% and 89.65%, respectively. Conclusion Two-dimensional strain echocardiography may accurately evaluate the coronary lesions by detecting regional myocardial diastolic function.

Female ; Humans ; Lymphoma ; diagnosis ; Pregnancy ; Pregnancy Complications, Neoplastic ; diagnosis

Fifty-four children, aged 1.5-3.5 years, were selected from a nursery and divided into three groups. To the children in group 1 multivitamin fortified formular milk powder of Hai-He brand (70g daily) was given as a supplementary food in addition to the normal diet and whole milk powder of Hai-He brand was given to group 2 as another supplementary food. The third group served as control. This observation was lasted for three months. At the end of the third month, the increments of body weight of the children, tricep skinfold and circumference of upper arm of group 1 were higher than those of group 3 significantly, but there were no significant differences between group 1 and group 2. The hemoglobin content of group 1 increased by 0.8g/dl but group 2 and 3 decreased by 0.53g/dl and 0.72g/dl respectively. At the end of our observation, the concentrations of vitamin B1, C and PP in urine of group 1 were higher than those of other two groups by vitamin load test.Thus, we may consider that the multivitamin fortified milk powder is better than the whole milk powder in improving the vitamin and iron nutritional status of young children.

Objective: To explore the influencing factors of slow blood flow phenomenon after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: Clinical and PCI angiographic data of 488 patients, who were diagnosed as AMI and received primary PCI in our hospital from Jan 2010 to Jun 2011, were retrospectively analyzed. Patients were divided into slow blood flow group (n=51, TIMI flow ≤ grade 2) and normal flow group (n=437, TIMI flow= grade 3). Their clinical characteristics between two groups were compared. Results: Compared with normal flow group, there were significant reductions in percentages of thrombus aspiration (75.3% vs. 60.8%) and application of platelet glycoprotein IIb/IIIa receptor antagonist (81.7% vs. 68.6%) during PCI, and significant rise in total length of implanted stents [(31.8±12.2) mm vs. (35.7±12.0) mm] in slow blood flow group, P<0.05 all. Multi-factor Logistic regression analysis indicated that percentages of thrombus aspiration during PCI and total length of stents were independent influencing factors for slow blood flow (P<0.05 both). Conclusion: Percentages of thrombus aspiration and total length of stents during PCI are independent influencing factors for slow blood flow.

Objective To investigate the effects of PTD4-GFP-Apoptin protein on proliferation inhibition and apoptosis-inducing of different types of leukemia cells. Methods Genetic engineering was used to restructure a carrier containing PTD4-GFP-Apoptin gene, and MTT was applied to detect the expressed PTD4-GFP-Apoptin fusion protein and its effect on the leukemia cell proliferation. Flow cytometry (FCM) was used to detect the effects on cell apoptosis. Results MTT cell proliferation inhibitory experiment showed that PTD4-GFP-Apoptin had different degree of proliferation inhibition on different types of leukemia cells;furthermore, the inhibitory effect presented positive correlation with time and concentration. FCM showed that PTD4-GFP-Apoptin had apoptosis-inducing effect on HL-60 cells, and the apoptotic rate had significant difference compared with the control group (P <0.05). Conclusions PTD4 can carry large proteins to penetrate the cell membrane, and PTD4-GFP-Apoptin may produce the inhibiting proliferation in vitro for a variety of leukemia cells. Apoptin can induce tumor cell apoptosis without affecting normal cells, which might become a new agent for the clinical treatment of leukemia.