The fall risk was evaluated with Modified Falls Efficacy Scale (Chinese version) in 426 elderly hypertensive patients (hypertensive group) and 436 elderly people without hypertension (control group) from rural communities in Zhejiang Quzhou areas.The fall risk scores were compared between hypertensive group and control group ; and also between patients with history of falls and those without falls.The results showed that the average score was 8.62 ± 2.15 in hypertensive group and 9.35 ± 1.35 in control group (P ＜ 0.01).The average score was 6.94 ± 1.85 in hypertensive patients with history of falls (n =112) and 9.22 ± 1.42 in without history of falls (n =314) (P ＜0.01).Our study suggests that there is a higher fall risk in elderly hypertensive patients than in elderly people without hypertension; and fall risk assessment with Modified Falls Efficacy Scale (Chinese version) can be used for prediction of fall for the elderly people in rural community.

Objective To investigate the correlations of extracellular matrix and hepatic ultramicrostructural changes with clinical manifestations in patients with mild chronic hepatitis B (CHB).Methods Patients with chronic HBV infections were enrolled and were divided into mild CHB group (n=66) and HBV carrier group (n=10).Serum samples were collected from patients, and serum HBV markers, HBV DNA load and liver fibrosis indexes were measured.All subjects received liver biopsy, and the tissue samples were observed by light microscope and electron microscope.T test and χ2 test were performed for measurement data and enumeration data, respectively.Spearman test was used for ranked data.Results The differences on ALT and AST levels between mild CHB group and HBV carrier group were significant (t=12.42, 7.06, P＜0.05), but there was no significant difference on HBV DNA load between two groups (t=0.24, P ＞ 0.05).Serum liver fibrosis indexes (hyaluronic acid, type Ⅲ collagen,type Ⅳ collagen and laminin protein) in mild CHB group were not significantly higher than those in HBV carrier group (t=0.45, 0.95, 0.76 and 1.21, P ＞0.05).In mild CHB group, there were 33 patients with ≥G2 and ≥S2, but in HBV carrier group were only 2 patients (χ2=4.17, P ＜ 0.05).Seventeen patients in mild CHB group were with S3-4, while that was not observed in HBV carrier group (χ2=4.75, P ＜0.05).In mild CHB group, hepatic ultramicrostrutural changes on fat storing cell, collagen protein and portal area were correlated with fibrosis grades, and the correlation coefficients were 0.351, 0.675 and 0.301, respectively (P=0.004, 0.000 and 0.014).Conclusion Electron microscope is of higher sensitivity than light microscope in observing hepatic ultramicrostructural changes, which is effective in evaluating the severity of mild CHB.

Background:Endoscopic ultrasonography( EUS)is the first choice for examining submucosal protuberant lesions in the gastrointestinal tract,however,it is very difficult to differentiate gastric stromal tumor from gastric leiomyoma. Photoshop software now is tried to differentiate some easily misdiagnosed diseases. Aims:To investigate the value of Photoshop software in differentiating EUS image of gastric stromal tumor from gastric leiomyoma. Methods:EUS image of 118 cases of gastric stromal tumor and 42 cases of gastric leiomyoma confirmed by pathological and immunohistochemical examination were collected,mean gray value( intensity of echo)and gray value standard deviation( uniformity of echo)of EUS image of lesion were determined by Photoshop software,and the differentiation value was analyzed. Results:The mean gray value of EUS image of gastric stromal tumor was significantly higher than that of gastric leiomyoma(71. 94 vs. 48. 99,P<0. 01). The gray value standard deviation of EUS image of gastric stromal tumor was significantly higher than that of gastric leiomyoma(16. 63 vs. 9. 80,P<0. 01). Conclusions:Under EUS,gastric stromal tumor exhibits higher intensity of echo and less uniformity of echo than gastric leiomyoma. EUS combined with Photoshop software is helpful for differentiating gastric stromal tumor from gastric leiomyoma by analyzing mean gray value and gray value standard deviation of the lesion.

Objective To identify the risk factors of Burkholderia cenocepacia associated nosocomial lower respiratory tract infections (NLRTIs),and to investigate the drug resistance of Burkholderia cenocepacia strains.Methods A total of 138 patients with Burkholderia cenocepacia associated NLRTIs and 40 patients with non-Burkholderia cenocepacia associated NLRTIs were enrolled in the study.All patients were collected from the Second Affiliated Hospital of Wenzhou Medical University during January 2009 and December 2012.Clinical data and results of drug sensitivity tests were retrospectively reviewed.Chi-square test and Logistic regression analysis were performed to identify the risk factors of Burkholderia cenocepacia associated NLRTIs.Results Logistic regression analvsis showed that combination use of 2 or more antimicrobial agents,mechanical ventilation,stay in intensive care unit (ICU) for more than two weeks,use of antacid H2 antagonist and deep venous puncture were the independent risk factors of Burkholderia cenocepacia associated NLRTIs (OR =6.315,5.957,5.254,4.585 and 2.017,P ＜0.05).Burkholderia cenocepacia strains were sensitive to levofloxacin,ceftazidime and sulfamethoxazole; More than 40％ strains were resistant to cefotaxime,ceftriaxone,cefepime,aztreonam and tetracycline; And nearly 100％ strains were resistant to gentamicin,amikacin and tobramycin.Conclusion Burkholderia cenocepacia associated NLRTIs are more likely to occur in patients with combination use of 2 or more antimicrobial agents,mechanical ventilation,and those who stay in ICU for more than two weeks,or received antacid and deep venous punctures,and most Burkholderia cenocepacia strains are multiple drug resistant.

Objectives To establish method for collecting haemocytes of Oncomelania hupensis and study its morphology and immunological importance. Methods Referring to the method of haemocytes collection from peripheral lymphoid organ, suspension technique was used for collection of haemocytes from snails, which were then Giemsa-stained and observed under microscope. Stained by gentian violet, number of haemocytes was counted and compared with that of conventional squashing method and needling method by ANOVA and Dunnett-t test. Supernatant from freeze thawing haemocytes was applied for the tests of immuno-precipitation, bacteriostasis, and phagocytosis. SDS-PAGE was used to analyze relative molecular mass of protein ingredients. Results Four kinds of haemocytes were found: round cells with filiform filopodia, acidophilic and basophilic round cells both without filiform filopodia, and spindle cells. The average diameter of the 4 type cells was 10.93, 6.13, 6.08, and 11:06?m, and occupied 50%, 30%, 5%, and 15% respectively. The mean of haemocytes received from suspension, squashing and needling methods was 15 000, 6 600 and 300/ml respectively. ANOVA analysis showed F=281.47, P

To obtain a primary overview of gene diversity and expression pattern in Lycoris longituba, 4,992 ESTs (Expressed Sequence Tags) from L. longituba bud were sequenced and 4,687 cleaned ESTs were used for gene expression analysis. Clustered by the PHRAP program, 967 contigs and 1,343 singlets were obtained. Blast search showed that 179 contigs and 227 singlets (totally 1,066 ESTs) had homologues in GenBank and 3,621 ESTs were novel.
Base Composition ; Computational Biology ; Expressed Sequence Tags ; Flowering Tops ; genetics ; Gene Expression Regulation, Plant ; Genetic Variation ; Lycoris ; genetics

Objective To investigate the expressions of platelet activation-dependent granule membrane protein and platelet-derived growth factor receptor-αB, and the ultra-microstructure changes of platelets in patients with acute ST-segment elevation myocardial infarction(STEMI). Method The expressions of platelet activationdependent granule of glycoprotein (CD62P)and platelet derived growth factor receptor αβ subtype (PDGFR-αβ)of platelets in peripheral blood in 36 patients with acute ST-segment elevation myocardial infarction(STEMI) hospitalized and another 34 healthy subjects over the same period (control group) were investigated by flow cytometry and data were analyzed. The changes of ultra microstructure and activity of blood platelets in those patients and control group were observed under the scanning electron microscope. Results The expressions of CD62P and PDGFR-αβin patients with STEMI group before treatment were (3.65 ± 1.87) % and (0.43 ± 0.39) %, respectively, and those after treatment were (0.96 ± 0.79) % and (0.28 ± 0. 24) %, respectively, whereas those in control group were (0.67 ± 0.35) % and (0.27 ± 0.22) %, respectively, which were much lower in control than those in patients with STEMI before treatment (P ＜ 0.01 or P ＜ 0.05) respectively. There were statistically significant differences in the expressions of CD62P and PDGFR-αβ in patients group between pre-treatment and posttreatment (P ＜0.01 or P ＜0.05), respectively. Obvious ultra-microstructure changes of platelet surface in patients with STEMI group were observed. Conclusions Due to platelet activation in AMI, the expressions of CD62P can be used as effective indicators for monitoring coronary heart disease, and the PDGFR-αβ can be used as a reference indicator. The platelet surface ultra-microstructure changes during platelet activation in patients with AMI can be found by scanning electron microscopy.

BACKGROUNDNon-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. Platelet activation may play an important role in pathologic progress in lung cancer. In this study, we aimed to clarify the influence of activated platelets on lung cancer generation and growth, and the relationship among these functional and ultrastructural changes of platelets and the severity of pathogenetic condition in these patients with NSCLC.

METHODSOne hundred and thirty-six cases of patients with pathologically confirmed NSCLC were included in this study. Fifty-four healthy people were enrolled as controls. The change of ultra microstructure and activity of blood platelets were observed under the transmission and scanning electron microscope. Simultaneous determination of plasma granule membrane protein 140 (GMP-140) was made.

RESULTSTransmission electron microscopy showed remarkable changes of ultra microstructure of platelets in patients with NSCLC, including swelling, increase of a-granules, vesicles, and glycogenosome. Scanning electron microscopy showed many more surface processes and wrinkles on platelets in patients with NSCLC. The reference plasma levels of GMP-140 of healthy controls were (18.2 +/- 2.7) microg/L. The plasma levels of GMP-140 in patients with NSCLC were (47.8 +/- 12.3) microg/L, which were much higher than those of the controls. There was a medium positive correlation between plasma levels of GMP-140 and amount of a-granules (r = 0.514, P < 0.01) and a high positive correlation between plasma levels of GMP-140 and area of platelet (r = 0.84, P < 0.01) in patients with NSCLC. The Kaplan-Meier survival curve analysis showed significant shift to the left in patients with NSCLC whose a-granules per platelet were 19 or more compared to those 18 or less (Log rank statistic, chi(2) = 17.38, P < 0.01).

CONCLUSIONSThere are significant activated changes of ultra microstructure and increased activity of blood platelets in patients with NSCLC. These activated platelets may play an important role in the generation and growth of lung cancer. These changes can be used as a diagnostic index of severity, progression, and prognosis of NSCLC.

Adult ; Aged ; Blood Platelets ; ultrastructure ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; mortality ; ultrastructure ; Female ; Humans ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; P-Selectin ; blood ; Survival Analysis

Objective To investigate the clinical significance of intraportal vein anticoagulation for the prevention of portal vein thrombosis after portaazygous devascularization and splenorenal shunt. Methods In this study 67 patients of portal hypertension undergoing surgery were randomly divided into two groups,receiving respectively intraportal vein heparin injection by 100 U?kg~(-1)?d~(-1)?7 d in group A (32 patients)and placebo in group B(35 patients).Portal vein thrombosis,the recurrent bleeding after operation and portal hypertensive gastropathy were compared between the two groups.Results The occurrence of portal vein thrombosis after operation in group A(0)was significantly lower than that in group B(20%,X~2=5.169,P

Objective:To investigate the influencing factors for major adverse cardiovascular events(MACE)in older patients with preserved ejection fraction(HFpEF)or with mid-range ejection fraction(HFmrEF)heart failure in the vulnerable phase.Methods:Data for 312 patients with preserved or mid-range ejection fraction heart failure hospitalized at the Department of Geriatrics, General Hospital of Tianjin Medical University from January 2017 to October 2019 were retrospectively collected, and 17 patients were lost to follow-up.A total of 295 elderly patients with preserved or mid-range ejection fraction heart failure were included in this study.According to whether major cardiovascular events occurred in the vulnerable phase(90 d after discharge), patients were divided into a MACE group(n=87)and anon-MACE group(n=208). Baseline data between the two groups were compared.Univariate logistic regression analysis wasused to determine risk factors for patients in the vulnerable phase, and COX regression analysis and Kaplan-Meier survival analysis were conducted to evaluate the influence of resting heart rate and hematocrit on MACE in the vulnerable phase.The predictive value of resting heart rate and hematocrit in MACE was analyzed by the ROC curve.Results:The resting heart rate at discharge in the MACE group was(78.6±6.9)bpm, higher than(71.1±8.4)bpm in the non-MACE group( t=7.30, P<0.01), whereas hematocrit was(32.3±3.6)%in the MACE group, lower than(36.6±4.9)% in the non-MACE group( t=-8.22, P<0.01). Resting heart rate and hematocrit were risk factors for MACE in elderly patients with HFpEF or HFmrEF in the vulnerable phase.Multivariate Cox regression analysis showed that HR was 1.11 for resting heart rate(95% CI: 1.07-1.14, P<0.001)and 0.91 for hematocrit(95% CI: 0.83-0.99, P=0.034). The survival times of patients with low and high resting heart rate were(86.5±1.2)d and(57.9±3.2)d, respectively.The survival rate of the high resting heart rate group(87.3%, 89/102)was lower than that of the low resting heart rate group(98.4%, 190/193)( χ2=116.30, P<0.01). The survival times of patients with high and low hematocrit values were(84.6±1.7)d and(67.0±2.4)d, respectively.The survival rate of the low hematocrit group(91.9%, 148/161)was lower than that of the high hematocrit group(97.8%, 131/134)( χ2=40.32, P<0.01). ROC curve analysis revealed that the cut-off values for resting heart rate and hematocrit were 73.5 bpm and 35.4%, respectively.The area under the ROC curve(0.919, 95% CI: 0.882-0.947, P<0.05)for the diagnosis of MACE using the combination of both parameters was significantly larger than that using resting heart rate(0.885, 95% CI: 0.843-0.919, P<0.05)or hematocrit(0.747, 95% CI: 0.694-0.796, P<0.05)alone. Conclusions:Resting heart rate and hematocrit are the main influencing factors for MACE in elderly patients with HFpEF or HFmrEF in the vulnerable phase.