Objective To test the reliability and validity of the Chinese version STRATIFY (St Thomas Risk Assessment Tool in Falling Elderly Inpatients) for geriatric inpatients.Methods The scale was translated and 404 geriatric inpatients were evaluated by the Chinese version STRATIFY and evaluate its reliability and validity.Results Chinese version STRATIFY was found with good feasibility.The Pearson correlation coefficient of reliability between testers was 0.951,the retest reliability was 0.885,internal consistency reliability (Cronbach's αt) was 0.523.The values of item-total correlation was over 0.3.The distinguish validity in difference of STRATIFY scores between groups with/without fall history was statistically significant.Predictive validity was moderate,the best cut-off point was determined at 2 points,and sensitivity and specificity were respectively 64.3％ and 78.2％.Conclusions Chinese version STRATIFY applied in Chinese geriatric inpatients showed good reliability between testers,retest reliability,distinguish validity and predictive validity,and it could be used to assess the fall risk of Chinese geriatric inpatients.In addition,as the internal consistency was lower,we can revise the entry of STRATIFY to provide a more accurate predicting tool.

Objective To study the influence of CYP3A5 genetic polymorphism on tacrolimus metabolism in renal transplantation recipients and evaluate the methods of detecting CYP3A5* 3 polymorphism. Methods Ninety-seven renal recipients receiving the triple immunosuppressive (tacrolimus + mycophenolate mofetil + prednison) were genotyped for CYP3A5* 3 polymorphisms by the Pyrosequencing TM assays. Tacrolimus trough concentration of the patients was measured by enzyme multiplied immunoassay technique, and concentration/adjusted dose ratio (C/D) was investigated at the 7th day, 14th day, 1st month, 3rd month and 6th month after renal transplantation. Results The Pyrosequencing TM assays allowed for quick and accurate detection of CYP3A5* 3 genotypes. There were CYP3A5* 1/* 1 genotype in 17 cases (17. 5%), * 1/* 3 in 35cases (36. 1 %) and *3/* 3 in 45 cases (46.4 %) identified in 97 renal recipients. The C/D of CYP3A5 * 1/* 1 and * 1/* 3 patients was significantly lower than that of * 3/* 3 patients (P<0. 01)after renal transplantation. Conclusion The CYP3A5* 3 polymorphisms are significantly correlated with tacrolimus pharmacokinetic in renal transplant recipients. Detecting the CYP3AS* 3 genotype of the recipient before the transplantation by the Pyrosequencing TM assays can be used to help determine the optimal initial dosage after transplantation, resulting in individualized drug therapy.

BACKGROUND: PM is known to induce various pulmonary diseases, including asthma, cancer, fibrosis and chronic bronchitis. Despite the epidemiological evidence the pathogenesis of PM-related pulmonary diseases is unclear. METHODS: This study examined the effects of PM exposure on the secretion of TNF-alpha and IL-1beta in the cultured alveolar macrophages. The cultured primary alveolar macrophages were treated with the medium, PM (5~20 microgram/cm2), LPS (5ng/ml), and PM with LPS for 24h and 48h respectively. ELISA was used to assay the secreted TNF-alpha and IL-beta in the culture medium. Western blotting was used to identify and determine the level of proteins isolated from the culture cells. The cells cultured in the Lab-Tek(R) chamber slides were stained with immunocytochemical stains. RESULTS: PM induced TNF-alpha and IL-1beta secretion in the culturing alveolar macrophages, collected from the SPF and inflammatory rats. However, the effects were only dose-dependent in the inflammatory macrophages. When the cells were co-treated with PM and LPS, there was a significant synergistic effect compared with the LPS in the both cell types. CONCLUSION: PM might be play an important role in the induction and/or potentiation of various lung diseases by oversecretion of TNF-alpha and IL-1beta.
Animals ; Asthma ; Blotting, Western ; Bronchitis, Chronic ; Coloring Agents ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Lung Diseases ; Macrophages ; Macrophages, Alveolar* ; Rats ; Tumor Necrosis Factor-alpha*

BACKGROUND: Particulate matters (PM) when inhaled is known to induce pulmonary diseases including asthma and chronic bronchitis when inhaled. Despite the epidemiological proofevidence, the pathogenesis of PM-related pulmonary diseases is unclearremain poorly understood. METHODS: Primary alveolar macrophages were harvested from the SPF and inflammatory rats by bronchioalveolar lavage (BAL). The cultured primary alveolar macrophages were treated with the medium only, PM only (5~40 microgram/cm2), LPS (5ng/ml) only, and PM with LPS for 24 and 48 hours. The level of secreted nitric oxide (NO) was assayed from the cultured medium by using the Griess reaction. The cultured cells were utilized for the western blotting against the inducible nitric oxide synthase (iNOS) proteins. Immunocyto- chemical staining against the iNOS and NT-proteins were performed in cells that cultured in the Lab-Tek(R) chamber slide after treatments. RESULTS: The PM that utilizein this experiments induced NO formation with iNOS expression in the cultured SPF and inflammatory rats alveolar macrophages, by itself. When the cells were co-treated with PM and LPS, there was a statistically significant synergistic effect on NO formation and iNOS expression over the LPS effect. The cells from the sham control showed minimal immunoreactivity for the NT-proteins. Significantly higher quantities of NT-proteins were detected in the PM and PM with LPS co-treated cells than from the sham control. CONCLUSION: Increased iNOS expression and NO formation with increased NT-proteins formation might be involved in the pathogenesis of PM-induced lung injury.
Animals ; Asthma ; Blotting, Western ; Bronchitis, Chronic ; Bronchoalveolar Lavage ; Cells, Cultured ; Lung Diseases ; Lung Injury ; Macrophages, Alveolar* ; Nitric Oxide Synthase Type II ; Nitric Oxide* ; Rats

PURPOSE: Headache patients with an alert mental state and normal neurologic examination findings who visit the emergency department (ED) should be differentially diagnosed for the presence of cerebral vessel disease. Hence, the purpose of this study was to analyze the abnormal three-dimensional cerebral computed tomographic angiography (3D-CTA) findings of mentally alert patients presenting headache, and investigate the clinical factors predictive of an intracranial abnormality. METHODS: A total of 227 patients visiting the ED presenting headache and possessing an alert mental status were enrolled in this study and examined by 3D-CTA from January 2008 to December 2008. We compared the results of the 3D-CTA and the final clinical diagnosis for each patient. The patient participants were divided into two groups: an abnormal group, as confirmed by 3D-CTA, and a non-abnormal group. We compared the vital signs, past hypertension history, clinical manifestations, and the clinical factors predictive of abnormality between the two groups. RESULTS: Of the total patients, 44 were identified with abnormal findings by non-enhanced CT, and 61 patients were identified with abnormal findings by 3D-CTA. SAH was found in 29 patients and unruptured aneurysm was discovered in 17 patients using 3D-CTA. The time interval between onset of headache to arrival at the ED was shorter in the SAH group (p=0.012), and sudden bursting headache was observed in 22 subarachnoid hemorrhage (SAH) patients (p<0.001). Statistically significant differences were observed between the two groups for symptoms of nausea, vomiting, neck stiffness and seizure. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables that affected the abnormal 3D-CTA group. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables for the abnormal 3D-CTA group. CONCLUSION: Sudden bursting headache, neck stiffness, vomiting, and advanced age were independent predictable variables observed in the abnormal 3D-CTA group.
Aneurysm ; Angiography ; Emergencies ; Glycosaminoglycans ; Headache ; Humans ; Hypertension ; Logistic Models ; Nausea ; Neck ; Neurologic Examination ; Seizures ; Subarachnoid Hemorrhage ; Vital Signs ; Vomiting

PURPOSE: Headache patients with an alert mental state and normal neurologic examination findings who visit the emergency department (ED) should be differentially diagnosed for the presence of cerebral vessel disease. Hence, the purpose of this study was to analyze the abnormal three-dimensional cerebral computed tomographic angiography (3D-CTA) findings of mentally alert patients presenting headache, and investigate the clinical factors predictive of an intracranial abnormality. METHODS: A total of 227 patients visiting the ED presenting headache and possessing an alert mental status were enrolled in this study and examined by 3D-CTA from January 2008 to December 2008. We compared the results of the 3D-CTA and the final clinical diagnosis for each patient. The patient participants were divided into two groups: an abnormal group, as confirmed by 3D-CTA, and a non-abnormal group. We compared the vital signs, past hypertension history, clinical manifestations, and the clinical factors predictive of abnormality between the two groups. RESULTS: Of the total patients, 44 were identified with abnormal findings by non-enhanced CT, and 61 patients were identified with abnormal findings by 3D-CTA. SAH was found in 29 patients and unruptured aneurysm was discovered in 17 patients using 3D-CTA. The time interval between onset of headache to arrival at the ED was shorter in the SAH group (p=0.012), and sudden bursting headache was observed in 22 subarachnoid hemorrhage (SAH) patients (p<0.001). Statistically significant differences were observed between the two groups for symptoms of nausea, vomiting, neck stiffness and seizure. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables that affected the abnormal 3D-CTA group. According to the results of the multivariate logistic regression analysis, sudden bursting headache and neck stiffness were independent predictable variables for the abnormal 3D-CTA group. CONCLUSION: Sudden bursting headache, neck stiffness, vomiting, and advanced age were independent predictable variables observed in the abnormal 3D-CTA group.
Aneurysm ; Angiography ; Emergencies ; Glycosaminoglycans ; Headache ; Humans ; Hypertension ; Logistic Models ; Nausea ; Neck ; Neurologic Examination ; Seizures ; Subarachnoid Hemorrhage ; Vital Signs ; Vomiting

Objective To investigate the feasibihty and superiority of transthoracic echocardiography(TTE)guided transcatheter occlusion for patent ductus arteriosus (PDA).Methods Totally 58 patients with simple funnel shape(Type A) PDA were studied retrospectively,and they were divided into angiography group(n =21) and echocardiography group(n =37).The angiography group received traditional transcatheter occlusion technique,and the echocardiography group received TTE guided transcatheter occlusion of PDA.An observation for the effect was taken post operatively,as well as for the comparison between the 2 groups in the aspects of the operation duration,the time of X-ray exposure,the radiation dose,the length of hospital stay and the expense of medication.Results Successful occlusion was performed in all patients.Both of the TTE and angiogram group showed good position of the occlusion devices.Moreover,the velocities of blood flow in left pulmonary artery and the descending aorta were in a normal range.Compared with angiography group,echocardiography group experienced shorter operation duration (P ＜ 0.05),shorter X-ray exposure time (P ＜ 0.05),lower radiation dose,fewer days of hospital stay (P ＜ 0.05) and less expense of the medication (P ＜ 0.05).Conclusions TTE-guided transcatheter occlusion for simple funnel shape PDA (Type A) is a simplified occlusion method,which is effective and preferential treatment to the method of traditional angiography guidance in clinical trials.

BACKGROUND: Low-density computed tomography (LDCT) improved early lung cancer diagnosis but introduces an excess of false-positive pulmonary nodules data. Hence, accurate diagnosis of early-stage lung cancer remains challenging. The purpose of the study was to assess the feasibility of using circulating tumour cells (CTCs) to differentiate malignant from benign pulmonary nodules. METHODS: 122 patients with suspected malignant pulmonary nodules detected on chest CT in preparation for surgery were prospectively recruited. Peripheral blood samples were collected before surgery, and CTCs were identified upon isolation by size of epithelial tumour cells and morphological analysis. Laser capture microdissection, MALBAC amplification, and whole-exome sequencing were performed on 8 samples. The diagnostic efficacy of CTCs counting, and the genomic variation profile of benign and malignant CTCs samples were analysed. RESULTS: Using 2.5 cells/5 mL as the cut-off value, the area under the receiver operating characteristic curve was of 0.651 (95% confidence interval: 0.538-0.764), with a sensitivity and specificity of 0.526 and 0.800, respectively, and positive and negative predictive values of 91.1% and 30.3%, respectively. Distinct sequence variations differences in DNA damage repair-related and driver genes were observed in benign and malignant samples. TP53 mutations were identified in CTCs of four malignant cases; in particular, g.7578115T>C, g.7578645C>T, and g.7579472G>C were exclusively detected in all four malignant samples. CONCLUSIONS CTCs play an ancillary role in the diagnosis of pulmonary nodules. TP53 mutations in CTCs might be used to identify benign and malignant pulmonary nodules.
Humans ; Lung Neoplasms ; Exome Sequencing ; Multiple Pulmonary Nodules ; Carcinoma ; DNA Repair