Objective To assess the effects of health management on high-risk diabetic populations.Methods A total of 307 diabetic high-risk adults from 6 communities of Tianjin were recruited by using diabetes risk screening technology.Three-month intensive health management and nine-month follow-up were conducted in this participants.Paired t test for continuous variables and paired contingency table x2 test were used for data analysis.Results Energy intake (1989.8 vs.1766.4 kcal,t =6.84,P ＜0.05),effective exercises (120.4 vs.157.5 kcal,t =-5.00,P ＜ 0.05),body weight (73.0 vs.71.5 kg,t =6.92,P ＜0.05),systolic blood pressure (130.4 vs.124.6 mm Hg (1 mm Hg =0.133 kPa),t =8.36,P ＜0.05),diastolic blood pressure (81.8 vs.78.4 mm Hg,t =7.40,P ＜ 0.05),serum total cholesterol (5.21 vs.5.08 mmol/L,t =2.73,P ＜ 0.05),fasting plasma glucose (6.4 vs.5.8 mmol/L,t =16.37,P ＜ 0.05)and 2 h postprandial blood glucose (7.7 vs.6.9 mmol/L,t =9.67,P ＜ 0.05) were significantly improved after the intervention.Conclusions Community-based health management may provide an effective way to prevent and control the risk factors of diabetes.

Objective:To investigate the expression of human epidermal growth factor receptor 2 (HER2) in pancreatic ductal adenocarcinoma(PDAC) and its relationship with the prognosis of patients with PDAC.Methods:From January 2001 to December 2012, 109 paraffin embedded PDAC tissue samples and 27 normal pancreatic tissue samples were collected from the Department of Pathology, Huadong Hospital Affiliated to Fudan University. The expression of HER2 protein in pancreatic tissue was detected by immunohistochemical Envision two-step method. HER2 expression was evaluated according to Hercept test, and its relationship with clinicopathological features and survival time was analyzed.Results:The expression of HER2 protein was negative (-) in 29.4% of PDAC tissues, weakly positive (+ ) in 35.8%, positive (+ + ) in 25.7% and strongly positive (+ + + ) in 9.2%, respectively, and the overexpression rate (+ + , + + + ) was 34.9%; the negative (-) and weakly positive (+ ) expression of HER2 protein in normal pancreatic tissues accounted for 88.9% and 11.1% respectively. There was no expression with positive (+ + ) or strongly positive (+ + + ), therefore, the overexpression rate was 0. The overexpression rate of HER2 protein in PDAC and normal pancreatic tissues was significantly different ( P=0.000). The expression of HER2 protein was significantly correlated with age, and the expression of HER2 protein in patients with PDAC over 65 years old was significantly higher than that in patients with PDAC under 65 years old ( P=0.043), but not with gender, tumor location, tumor grade, T stage, N stage and nerve invasion (all P>0.05). Univariate Cox proportional hazards analysis showed that HER2 expression was associated with postoperative survival time of patients with PDAC ( P=0.032). Multivariate Cox proportional hazards analysis showed that HER2 expression was an independent prognostic factor for survival of patients with PDAC ( P=0.040). The median survival period of patients with HER2 expression + + + was significantly longer than that of patients with HER2 expression -~+ + (128.4 months vs 21.5 months), and the difference was statistically significant ( P=0.038). Conclusions:The overexpression of HER2 in PDAC tissue was related to the age of patients. The survival time of patients with HER2 strongly positive PDAC was significantly longer. HER2 can be considered as an index to evaluate the biological behavior and prognosis of PDAC.

OBJECTIVETo discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis.

METHODSFrom November 2009 to November 2010, 86 patients (104 fingers) with fingertip amputation were treated with replantatioin, including 64 males and 22 females, with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h, time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases: (1) replantation with anastomosis of single or bilateral proper digital artery in 37 fingers; (2) replantation with arteriovenous bypass in 27 fingers; (3) replantation with exclusive anastomosis of digital artery in 24 fingers; (4) replantation with removing the palmar pocket method in 16 fingers.

RESULTSOne hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases (92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 52 cases, good in 19, poor in 4.

CONCLUSIONIt benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope.

Adolescent ; Adult ; Amputation ; Child ; Child, Preschool ; Debridement ; Female ; Fingers ; physiology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Replantation ; methods ; Young Adult

Medical imaging is an interdisciplinary subject closely related to clinical and pathological subject. Its clinical reading skills' training has become the focus of postgraduate teaching. In the process of clinical teaching, the interactive reading mode of problem-based learning (PBL) combined with multi-disci-plinary team (MDT) was introduced into clinical reading meeting. The tutors chose the reading cases proved by pathology; designed in-depth issues step by step for execution of PBL teaching; guided postgraduates to delineate imaging signs and propose the diagnostic results, evidences and differential diagnoses according to the step from localizing to qualitative and then to pathological diagnosis;then guided postgraduates to attend in-depth case analysis of MDT and analyze the correlation or inconsistency between the imaging diagnosis and clinical and pathological diagnosis; exercise document retrieval and verbalization, multimedia design, and writing level of the records of the reading cases and papers. The interactive reading mode of PBL com-bined with MDT has achieved significant effects, which is worthy of further exploration and promotion.

Purpose: The purpose of this study was to investigate the prevalence and risk factors of overactive bladder (OAB) in young adults and to explore the influence of OAB on mental health. Methods: Between October 2019 and January 2020, 14,010 anonymous questionnaires were distributed to freshmen at 2 universities in Henan, China. The students came from all over the country. The questionnaire included general items and information necessary to calculate the overactive bladder symptom score, the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) score, Self-Esteem Scale (SES) score, and Self-Rating Depression Scale (SDS) score. The relationships between the prevalence of OAB and its risk factors were evaluated. Results: The overall prevalence of OAB was 6.0%, with 4.3% of participants characterized as having dry OAB and 1.7% as having wet OAB. The prevalence of mild OAB was 5.5%, and that of moderate OAB was 0.5%; no severe OAB was observed. Higher prevalence rates of OAB were found among women, respondents with constipation, and respondents with primary nocturnal enuresis (PNE) (P <0.05). Compared to healthy controls, the OAB group exhibited a higher mean SDS score (52.12±8.986 vs. 47.71±9.399, P<0.001) and mean PSQI score (5.28±2.486 vs. 4.27±2.431, P<0.001), but a lower mean SES score (27.78±3.599 vs. 29.57±4.109, P<0.001). Conclusions OAB significantly affects the mental health of young adults. Female sex, constipation, and PNE are risk factors for OAB.

AIMTo observe the effect of FAK-related non-Kinase (FRNK) plasmid on hepatic stellate cell (HSC) proliferation stimulated by fibronectin (FN).

METHODSFRNK plasmid was transfected into HSC with transient liposomal transfection. The proteins of FRNK, FAK and p-FAK(Tyr397) were assayed by Western blotting analysis. The proliferation of HSC was evaluated by improved MTT assay, and cell cycle pattern was determined by flow cytometry (FCM).

RESULTS(1) The expression of FRNK protein increased after FRNK transfected HSC, and it was at 48 h that the expression of FRNK protein was the highest (P < 0.01). The protein level of FAK was no significant difference between before FRNK plasmid transfection and after transfection (P > 0.05). The expression of p-FAK(Tyr397) protein was down-regulated after FRNK had been transfected in HSC, (P < 0.01). (2) The HSC proliferation inhibition rates at 12 h, 24 h and 48 h after FRNK transfection were 20.07%, 26.16%, 29.77%, respectively (P < 0.01). (3) Compared with the non-FRNK plasmid group, the FRNK-transfected HSCs almost arrested in G0/G1 phase (71.4 +/- 2.81 vs 48.9 +/- 1.66, P < 0.01).

CONCLUSIONAfter FRNK were transfected successfully in HSCs using lipofectamine, the phosphorylation of FAK was inhibited. The HSC proliferation was restrained in a time-dependent manner and the HSC was arrested in G0/G1 phase.

Cell Line ; Cell Proliferation ; Fibronectins ; Hepatic Stellate Cells ; cytology ; Humans ; Phosphorylation ; Plasmids ; genetics ; Protein-Tyrosine Kinases ; genetics ; Transfection

The pathomechanisms of the progression of chronic kidney disease (CKD) include glomerulosclerosis, renal interstitial fibrosis and renal arteriosclerosis. Chinese herbal medicine can delay the progression of CKD by ameliorating the harmful factors of these pathological changes, such as podocyte and slit diaphragm injury, nephrotoxicity of proteinuria, hyperactivity of renin-angiotensin-aldosterone system, cytokines over-expression, tubular epithelial myofibroblast transdifferentiation, hyperlipidemia and hypertension.
Chronic Disease ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Kidney Diseases ; drug therapy ; metabolism ; Renin-Angiotensin System ; drug effects ; Transforming Growth Factor beta ; metabolism

Objective To investigate the morphological differences of proximal femoral medullary cavity in elderly patients with intertrochanteric fracture and its effect on the treatment efficacy of proximal femoral nail antirotation (PFNA). Methods A retrospective case series study was conducted on the clinical data of 112 elderly patients with intertrochanteric fracture of the femur from December 2012 to January 2017, including the preoperative and postoperative hip joints orthotopic X ray (including the proximal femur), lateral X ray, and pelvic orthotopic X ray films. The proximal femoral canal flare index (CFI) and the metaphyseal canal flare index (MCFI) were measured. The proportion of patients with different types of medullary cavity and the gender difference were analyzed according to Dorr typing. The fractures were classified according to the modified Evans classification. Operation time, fracture reduction quality, tip apex distance (TAD), incidence of intraoperative split fracture around the rotors, postoperative fracture reduction loss rate, weight bearing time, and fracture healing time were recorded. Results The proximal femoral canal flare index (CFI) was significantly correlated with the intramedullary diameter above the lesser trochanter, the inner diameter of the affected side medullary cavity isthmus, and metaphyseal canal flare index (MCFI) (P ＜0.01). There was clear difference in gender in terms of the medullary cavity diameter 20 mm above the middle point of lesser trochanter, medullary isthmus internal diameter, the medullary cavity diameter 20 mm below the middle point of lesser trochanter, CFI, and MCFI. Thereinto, there was significant difference in the medullary cavity diameter 20 mm above the middle point of lesser trochanter [male (52.6 ± 6.4) mm, female: (49.9 ± 5.4) mm], the medullary cavity diameter 20 mm below the middle point of lesser trochanter [male: (26.5 ± 3.7) mm, female: (23.1 ±2.8)mm], and MCFI (male:2.0 ±0.3, female:2.2 ±0.2). No significant difference between the medullary isthmus internal diameter and CFI was found (P＞0.05). In this group, the medullary cavity of proximal femur was classified by Dorr: the proportion of funnel type, normal type, and chimney type was 5.4％ (6/112), 73.2％ (82/112), and 21.4％ (24/112), respectively. There was no significant difference in the modified Evans fracture stability among different morphological types of the proximal femoral medullary cavity. The difference of weight bearing time between normal group and chimney group was statistically significant [normal type: (21.4±16.9)d, chimney type: (45.5 ± 11.2)d] (P ＜ 0.05), but there were no significant differences in operation time, reduction quality, TAD, intraoperative incidence of cleavage fracture incidence, reduction loss rate, and healing time between the two groups (P＞0.05). Conclusions The occurrence and development of osteoporosis can cause significant changes in the morphology of proximal femoral medullary cavity, mainly manifesting as the gradual increase of the proportion of chimney type. The efficacy of PFNA in treatment of the intertrochanteric fracture is satisfactory. However, the risk of intraoperative cleavage fracture and postoperative reduction loss should be taken seriously.

Objective:To explore the automated external defibrillator (AED) configuration optimization strategy in line with the characteristics of the rapidly developing cities by analyzing the actual coverage of AED in Bao'an District based on the real world data of out-of-hospital cardiac arrest (OHCA) in Bao'an District, Shenzhen City.Methods:The data of cardiac arrest database registered in Bao'an District of Shenzhen City from March 1, 2019 to February 29, 2020 were included in a retrospective observational study. The AED coverage of public and non-public areas was analyzed by calculating the minimum distance between the occurrence place of each OHCA event and the nearest AED. The minimum distance ≤100 m was set as AED coverage, and the minimum distance > 100 m was set as non-AED coverage. It was assumed that one AED was configured for each OHCA hotspot area, then the AED coverage changes were analyzed. Based on the actual situation that the AED in schools, governments, sports venues, subways, tourist attractions and parks of public areas in Bao'an District could not be obtained at any time within 24 hours, it was assumed that all AED in the public areas could be obtained at any time within 24 hours, the impact of AED available at any time on AED coverage was analyzed.Results:A total of 525 cases of OHCA were enrolled. The highest incidence of OHCA was found in residential and industrial areas [54.5% (286/525) and 14.3% (75/525), respectively]. There were 252 AED in Bao'an District, Shenzhen, and 115 OHCA events occurred within the coverage area of AED. Even if all AED met the ideal state that could be obtained at any time within 24 hours, the coverage rate was only 21.9% (115/525). The AED coverage rate of the public areas and non-public areas was 31.6% (37/117) and 19.1% (78/408) respectively, with uneven distribution, and the AED coverage rate of non-public areas was low. Assuming that the residential community and industrial zone with more than 2 OHCA cases were respectively equipped with one AED, the coverage rate of AED in the non-public areas increased from 19.1% (78/408) to 28.2% (115/408), basically meeting the requirement that AED could be obtained at any time when OHCA events occurred. Some AED in the public areas of Bao'an District were not available at any time within 24 hours. If the ideal state that all AED in the public area could be obtained at any time within 24 hours could be achieved, the AED coverage rate of all regions increased from 16.8% (88/525) to 21.9% (115/525), the AED coverage rate of the public areas increased from 29.1% (34/117) to 31.6% (37/117), the AED coverage rate of the non-public areas increased from 13.2% (54/408) to 19.1% (78/408).Conclusions:AED configuration in Bao'an District was unevenly distributed, and the coverage rate of AED in non-public areas was low. The allocation strategy for AED in fast-growing cities like Shenzhen should be as follows: on the premise of ensuring AED availability for 24 hours, priority should be given to covering the number of AED in the non-public areas including residential communities and industrial zones; AED is available in the public areas for 24 hours.

OBJECTIVETo evaluate the safety, effectiveness, and outcomes of holmium laser enucleation of the prostate (HoLEP) for patients with symptomatic enlarged prostate after 11 years of experience.

METHODSThe 3162 evaluable patients treated with holmium laser enucleation of the prostate at our institution between August 2001 and August 2011 were retrospectively analyzed. Study variables included International Prostate Symptom Score, quality of life, maximum urinary flow rate, and incidence of complications.

RESULTSHoLEP were performed successfully completed, not patients which occurs as electric cutting syndrome. The operation time was (60.8 ± 18.4) minutes; average resection of prostate quality was (45.4 ± 24.4) g. The hemoglobin reduce though surgery was (1.81 ± 0.93) g/L; percentage of red blood cell change was 1.24% ± 0.43%, and sodium blood drop was (1.14 ± 0.35) mmol/L. Postoperative patients of hospital stay (3.1 ± 1.1) days, average time of indwelling catheter time was (2.3 ± 0.8) days. Patients were followed up for 6-131 months time, an average of 32.4 months. Postoperative patients with international prostate symptom score progressive declined. The quality of life score was 2.2 ± 1.7, and it less than preoperative (5.7 ± 3.3, t = 2.447, P < 0.01). The time of follow-up droped further, and postoperative comparative differences have statistical significance (t = 2.179, 2.228, 2.306 and 2.365, P < 0.05). The maximum urinary flow rate also improved (P < 0.05). Postoperative complications included bladder neck contracture (4 cases), urinary tract infection (107 cases), urethral stricture (11 cases) and urinary incontinence (11 cases). The 11 patients reoperation.

CONCLUSIONSHoLEP treatment of benign prostatic hyperplasia could achieve the advantages of open surgery the same effect. It had fewer damage, faster recovery, fewer complications, and is a good treatment option.

Adult ; Aged ; Aged, 80 and over ; Humans ; Lasers, Solid-State ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome