Objective To explore the coastal state of hypertension among rural population and its relationship between the prevalence of metabolic syndrome(MS).Methods Lianyungang coastal rural residents 11089 people for primary hypertension epidemic learn research,age qualified for 45～75age,measurement height,body quality,waist,blood pressure,lipid and fasting blood glucose,respectively in accordance with international diabetes Union(IDF)and CDS of MS diagnosis standard calculation illness rate,and on gender,age,and hypertension level(Ⅰ,and Ⅱ,andⅢ,level),effects factors for correlation analysis.Results 11089 people(male 3985 people,female 7104 people)in the IDF standard MS total illness rate for 44.3％(male,and female MS illness rate respectively for 25.4％,and 54.9％),CDS standard MS total illness rate for 37％,two species diagnosis standard of meet rate for 79.9％;except blood glucose outside,female residents waist,TG,and HDL-C,indicators exception occurs rate obvious than male(x2=1399.198,554.801,652.110,all P＜0.01).Conclusion Lianyungang coastal MS prevalence in rural areas is higher than the general average in the middle-aged;female patients with hypertension and obesity are very high risk population of MS;hypertension pathogenesis is longer,higher prevalence of MS.

OBJECTIVE To investigate the incidence and pathogens of infection in 1659 consecutive cases in single center hematological unit.METHODS The incidence,pathogen,and outcome of infection in 1659 hospitalized patients with hematological disorders from 1999 to 2006 were retrospectively analyzed.RESULTS The overall incidence of infection was 24.4% according to the person-times of hospitalization,which included 22.1% of nosocomial infection and 2.3% of community acquired infection.Most of the pathogenic bacteria of the nosocomial infection were Gram-negative.The most common bacteria in the sputum samples included Enterobacter cloacae(19.3%) and Pseudomonas aeruginosa(14.8%).The most common bacteria in the blood samples were coagulase negative Staphylococcus(CNS,39.3%),the next was Pseudomonas aeruginosa and Escherichia coli.There were 4.21% bacteria resistant to most of antibiotics in nosocomial infection.There were 114 fungi isolated.Candida albicans was accounted for 35.1%.The mortality due to nosocomial infection was 7.4%.CONCLUSIONS The patients in hematology ward are susceptible to infection.The pathogens of nosocomial infection are most likely G-bacteria.Some bacteria are resistant to almost all antibiotics.The incidence of fungal infection is increasing in the near 8 years.

Objective To explore the cytogenetic characteristics of acute myeloid leukemia(AML) patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128(74.9%)had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome (MDS-AML),with 25 (92.6%) patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103(71.5%)had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML (P=0.021).Among the 171 patients,41(24.0%)were in favorable risk group,80(46.8%)in intermediate risk group and 50(29.2%)in adverse risk group.t(15;17)was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger(P=0.03 1).The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients(P<0.001).Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t(15;17),normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.

Objective To investigate the prevalence by age,response to different therapies and outcome in newly diagnosed idiopathic thrombocytopenic purpura(ITP). Methods ITP patients who were hospitalized from July 1992 to December 2006 and followed uD with telephone were retrospectively analyzed.Results 103 patients with ITP were investigated. The time of follow-up was between 2 months to 15years.to adrenocorticosteroid and 4 patients under going splenectomy achieved a normal platelet count. In those immunosuppressive agents:including vincristine,cyclophosphamide,azathioprine and cyclosporin A(CsA)used in the present series. CsA was shown to be more effective. It could increase the platelet count when given together with prednisolone,the effective rate was 81.3%(26/32). Severe side effects like kiney function failure were not found in CsA treated patients so the use of geug in ITP would be recommended.There were 2,1 and 1 ITP patients progressing respectively to Sjogren's syndrome,systemic lupus erythematosus and lymphoma. 7 patients died,1 patient died of cerebral bleeding,2 brain infarction,3 malignant neoplasm and 1 nephrosis The refractory rate of ITP is 17.2%(10/58). Conclusions The morbidity in older people is high. The mortal bleeding in ITP is low. Treatment should be tailored to the individual patient.

Objective To explore the karyotype distribution in elderly patients with acute leukemia (AL) and compare the prognostic characteristics of karyotype by age grouping.Methods Chromosomal karyotypes were analyzed in 215 cases with AL using the short-term culture of bone marrow cells and G-banding technique.Results There were 202 cases with enough mitosis for analysis and 149 cases(73.8％)with abnormal clone in 215 patients with AL.The rates of abnormal clone were 73.0％ (27/37),74.4％(64/86) and 73.4％ (58/79) in patients aged ≤30,31-59 and ≥60 years,respectively,and no difference were found among age groups (P=0.982).Among 171 patients with acute myeloid leukemia (AML) with detected mitosis,there were 41 better-risk cases (24.0 ％) with most frequent aberration of t(15;17) accounting for 65.9 ％,80 intermediate-risk cases (46.8 ％ ) with principal of normal karyotype accounting for 53.8 ％,and 50 poor-risk cases (29.2 ％)with complex karyotype occupied by 84.0％.The karyotype percentage of better-risk,intermediaterisk and poor-risk were 50.0％,36.4％ and 13.6％ in patients aged ≤30 years,24.3％,48.7％ and 27.0％ in aged 31-59 years,and 16.0％,48.0％ and 36.0％ in aged ≥ 60 years,respectively.The rate of better-risk karyotype was higher in patients aged ≤30 years than the other two groups (P=0.021and P=0.001) and the ratio of poor-risk karyotype higher in patients aged ≥ 60 years than in patients aged ≤30 years (P=0.046).Among 29 patients with acute lymphoblastic leukemia (ALL),10 cases had poor-risk and 19 cases had intermediate-risk karyotype.Conclusions Karyotype analysis provides an important basis for risk assessment and the rate of poor-risk karyotype may increase with the ageing in patients with AML.

Objective To evaluate the effect of a modified culture method on the karyotype anomalies detection rate in elderly patients with multiple myeloma (MM),and to explore the relationship between clinical characteristics and chromosome anomalies in multiple myeloma.Methods Two culture methods were applied on the bone marrow samples which obtained from 28 MM patients.One method was used to culture cells for 24 hours with interleukin 6 (IL-6) 10 μg/L and granulocyte-macrophage colony-stimulating factor (GM-CSF) 40 μg/L,and the other for 6 days.Karyotype was analyzed by G-banding technique.Results In the 24-hour culture group,no metaphases cell was found in 4 cases (14.3 ％),karyotype anomalies were found in 6 cases in the other 24 cases,and the detection rate was 25.0％ (6/24).In the 6-day culture group,no metaphases cell was found in 1 patient (3.6％),karyotype anomalies were found in 15 cases in the other 27 patients,and the detection rate was 55.6％ (15/27).There was a significant difference in the detection rate of karyotype anomalies between the two groups (x2 =4.89,P ＜ 0.05).In 27 cases with enough metaphases in the 6-day culture group,20 cases were newly diagnosed or in progression,among whom karyotype anomalies were found in 14 cases (70.0％,14/20),and 7 cases were in stable phase,among whom karyotype anomalies were found in 1 case (14.3％,1/7).The detection rate of abnormal karyotype was higher in newly diagnosed or in progressive patients than in stable patients (P ＜0.05).Conclusions 6-day culture method can improve the detection rate of karyotype anomalies in elderly patients with multiple myeloma,which is better than 24-hour culture method.The detection rate of karyotype anomalies is higher in newly diagnosed or in progressive patients than in stable patients.

Objective:To evaluate the clinical efficiency and prognostic factors of autologous peripheral blood stem cell trans-plantation (APBSCT) in 30 cases of multiple myeloma (MM). Methods:Two of the 30 patients received the second treatment of APB-SCT because of relapse after the first treatment. Thus, a total of 32 case-times of APBSCT were studied. Combination chemotherapy was inducted regularly before APBSCT (11 patients used bortezomib as an induction drug), and chemotherapy combined with the G-CSF regimen was used to mobilize peripheral blood stem cells. Preconditioning was based on melphalan. Results:Mononuclear cells in harvest were 6.41 × 108/kg, and CD34+cells in harvest were 4.75 × 106/kg. The median times of neutrophil and platelet engraftment were 9.5 and 11 d, respectively. The complete remission (CR) and very good partial remission (VGPR) rates were 37.5%and 34.4%af-ter APBSCT, respectively. The median overall survival (OS) was 67.27 months in all patients, and the median progression-free survival (PFS) was 29.77 months. The median PFS rates were 29 and 20 months in the patients who achieved CR and PR, respectively, and the median PFS was not observed in the patients who achieved VGPR. Statistical differences in PFS were detected between the CR+VGPR and PR groups (P=0.025). The CR rates were 63.6%and 23.8%in the bortezomib (bortezomib-based chemotherapy) and non-bortezo-mib groups (P=0.034), respectively. The median OS and PFS were not obtained in the bortezomib group, whereas the median PFS was 22 months in the non-bortezomib group (P=0.045). Conclusion: MM patients treated with bortezomib-based chemotherapy followed by APBSCT had prolonged PFS. APBSCT can improve the response and survival of MM patients.

Objective To explore the clinical and biological characteristics and treatment effect of acute myeloid leukemia (AML) in elderly patients. Methods The clinical data of 62 patients over 60 years old with AML were retrospectively analyzed, and they were compared with those of 60 younger adult patients (18-59 years old) at the same period. Results In elderly patients, the complete remission (CR) rate was 27. 7% and the overall effective rate was 44.7%, which were lower than those of younger adult patients (74.1% and 87.9 %, 1-espectively, P＜0.01). The early death rate was 19.0% and the mortality rate during the first two induction chemotherapy was 29. 3% in the elderly, which were higher than those of younger adult patients (3. 3% and 6.7%, 1-espectively,P＜0.01). The 27.4% of elderly patients were diagnosed as myelodysplastic syndrome (MDS)-transformed AML, which were more than that of younger adult patients (10.0%, P＜0.05), and they had lower CR rate than those without MDS (P＜0. 05). The 28.2% of elderly patients had lymphoid antigen positive AML and 71.8% of patients showed CD34+ which were higher than those of younger adult patients (8. 1% and 48.6%, respectively, P＜0. 05), and they had lower CR rate than those of lymphoid antigen negative and those of CD34- AML (P＜0. 05). Elderly patients had less favorable and more unfavorable karyotypes than younger adult patients (45.7 % and 15.4 %, P＜0. 05). Conclusions The elderly patients with AML have more unfavorable prognostic factors than younger adult patients. They have lower CR rate and higher mortality rate. There are many specialties in elderly patients and the treatment strategy should be made more individually.

OBJECTIVETo study the therapeutic method and clinical effect of domestic locking plate for treating fracture of the tubiform bone through a minimal incision and bridging fixation.

METHODSAmong 40 patients with fracture of the tubiform bone, 29 patients were male and 11 patients were female, aged from 29 to 69 years, with the average of 38.27 years. Among 34 patients with closed fracture, 7 cases were type A, 10 cases type B, 17 cases type C according to AO/ASIF classification. Among 6 patients with open fracture, 2 cases were type I, 4 cases were type II according to Gustilo classification. These patients were treated with a small incision after manipulative reduction. Locking plate and 3.5 mm diameter Kirschner wire were used to maintain the reduction and through the C-arm X-ray machine to check and adjust the position, screw were locked to bridging fixation at last.

RESULTSForty cases were followed up in 6 months on average (ranging from 4 to 10 months). The average time of union of fracture was 4.6 months (ranging from 3 to 8 months). According to Ovadia typing, the results were excellent in 16 cases, good in 20 cases, fair in 3 cases,poor in 1 case. The excellent and good rate was 90%.

CONCLUSIONSThe domestic locking plate is suitable for patients with osteoporosis and comminuted fracture because of the advantages of reliable fixation and low price. It could achieve the same effect of minimal invasive as LISS (less invasive stabilizing system) plate through the improvement of operative method.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

Objective To study the inducing factors and clinical characteristics of patients hospitalized for asthma exacerbation in China. Methods Patients hospitalized for asthma exacerbation at 29 hospitals in China were retrospectively recruited during 2013-2014. Results Clinical data of 3 240 asthmatic patients were collected and analyzed including 1 369(42.3%) males and 1 871(57.7%)females. The patients hospitalized for asthma exacerbation counted for 2.95% (6 375/215 955) of all patients hospitalized during the same period. The leading six inducing factors, in sequence, were acute upper respiratory tract infection[42.3%(1 370/3 240)],changes of weather[22.8%(738/3 240)],noxious gas[(4.3% (140/3 240), allergy challenges [3.5%(115/3 240)], strenuous exercise [1.8%(57/3 240)], and air pollution [1.5%(49/3 240)].In older patients,more exacerbations were induced by weather changes,yet less sensitive to allergy challenges. As to middle-aged patients, they were less sensitive to upper respiratory tract infections,however the difference was not statistically significant(P>0.05).In winter more asthma patients were induced by upper respiratory tract infections,while in autumn more patients were induced by weather changes,strenuous exercise and air pollution.In spring and summer more patients were induced by allergy challenges, but the differences failed to achieve statistical significance (P>0.05). In northern cities more patients were induced by upper respiratory infections, whereas in southern cities more by noxious gases. Allergy challenges and air pollution tended to affect more patients in northern cities,but the difference was of no significance (P>0.05). The differences of inducing factors among patients of different gender, with or without a smoking history, and with different exacerbation severity didn't show any statistical significance. The patients with severe and life-threatening exacerbations counted for 20.1%(652/3 240).The percentage of patients older than 60 years was higher in patients with severe or life-threatening exacerbations than in whose with mild or moderate exacerbations,so did the percentage of male patients,of patients with disease duration longer than 10 years, with smoking history, and with a history of hospitalization or emergency department visits due to asthma exacerbation during the last year.Conclusion The acute upper respiratory tract infection ranks top among all the inducing factors. Senility, male gender, long duration of disease, smoking history, and a history of frequent hospital visits might be the risk factors for severe or life-threatening asthma exacerbations.