Objective To explore the risk factors for community-acquired pneumonia (CAP) in the elderly,in order to provide the basis for clinical prevention and treatment.Methods 168 elderly patients with CAP (observation group) and 100 elderly patients without CAP (control group) were chosen from our hospital from Jan.2013 to Dec.2014.The clinical data were investigated,and the risk factors for CAP were analyzed.Results Single factor analysis showed that there were significant differences between the two groupsin serum protein level,pets-raising,smoking,dust exposure,bronchial disease,renal dysfunction and diabetes mellitus (all P＜0.05).Multivariate logistic regression analysis showed that serum protein level,pets-raising,smoking,bronchial disease and diabetes were the independent risk factors for CAP in the elderly (OR=2.793,2.578,3.017,3.168 and 2.643,all P＜0.05).Conclusions The community-acquired pneumonia is related with many risk factors in the elderly.The clinical corresponding prevention and treatment for the risk factors should be developed,which have an important significance in the early diagnosis,early treatment and prognostic improvement in community-acquired pneumonia.

Objective:This study aimed to investigate the effect of human lymphatic endothelial cells (HLECs) on proteins secreted by epithelial ovarian cancer (EOC) cells SKOV3-pm4 with highly directional lymphatic metastasis. Methods:The supernatants of the four groups of cultured cells (A, SKOV3;B, SKOV3+HLEC;C, SKOV3-PM4;and D, SKOV3-PM4+HLEC) were collected. The proteins of these cells were detected by antibody arrays and iTRAQ-2D-LC-MALDI-TOF/TOF/MS. The screened significantly differential proteins were further analyzed by bioinformatics and validated in the human serum and cell culture medium by ELISA. Results:Progranulin (GRN) and vascular endothelial growth factor A (VEGF-A) were upregulated between groups C and A. In addition, insulin-like growth factor binding protein-7 (IGFBP-7) and secreted protein acid rich in cysteine (SPARC) were downregulated between groups D and C. Comprehensive bioinformatics analysis revealed that IGFBP7 interacted with VEGFA. VEGF exhibited the highest expression in ovarian cancer and IGFBP7 exhibited the lowest expression compared with the serum of the normal control group. Statistically significant differences were observed between the two substances. Conclusion:The HLEC microenvironment is closely associated with directional metastasis in lymph nodes with differential proteins, including matricellular proteins and adhesion factors. In particular, the upregulation of VEGFA and GRN and the downregulation of SPARC and IGFBP7 were closely associated with the directional metastasis of EOC cells in lymph nodes.

Objective To investigate the diagnostic value of texture analysis derived from conventional MR imaging in differentiating benign and malignant breast lesions. Methods Thirty-six patients with malignant breast lesion and 33 patients with benign breast lesion were retrospectively analyzed in our study. All patients underwent conventional MR imaging including axial T1WI, T2WI, and contrast-enhanced T1WI before surgery. Texture features were calculated from manually drawn ROIs by using MaZda software. The feature selection methods included mutual information (MI), Fishers coefficient, classification error probability combined with average correlation coefficients (POE + ACC) and the combination of the above three methods(FPM). These methods were used to identify the most significant texture features in discriminating benign breast lesion from malignant breast lesion. The statistical methods including raw data analysis (RDA), principal component analysis (PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were used to distinguish malignant breast lesion from benign breast lesion. The results were shown by misclassification rate. Results In the three kinds of sequences, the texture features for differentiating malignant breast lesion and benign breast lesion were mainly from T2WI which had the lowest misclassification rate 4.35%(3/69). The misclassification rates of the feature selection methods were similar in MI, Fisher coefficient and POE+ACC (15.94%to 56.52%for MI;17.39%to 56.52%for Fisher coefficient and 17.39%to 56.52%for POE+ACC). However, the misclassification rate of the combination of the three methods (4.35%to 53.62%for FPM) was lower than that of any other kind of method. In the statistical methods, NDA (4.35% to 27.54%) had lower misclassification rate than RDA (33.33% to 56.52%), PCA (33.33% to 53.62%) and LDA (15.94% to 44.93%). Conclusion Texture analysis of conventional MR imaging can provide reliably objective basis for differentiating benign from malignant breast lesions.

Objective: To analyze environmental and health literacy and associated factors of medical students in Gansu Province, and to provide reference for targeted environmental and health education. Methods: The questionnaire was designed based on the "core questions of citizen environmental and health literacy assessment" in the technical guide for citizen environmental, and demographic characteristics were added appropriately. The stratified cluster sampling method was used to selecte 6 619 medical students in Gansu Province as respondents. Results: The proportion of medical students in Gansu Province with environmental health literacy was 5.7%. The proportions of basic literacy, basic knowledge, and basic skills were 14.2%, 1.8% and 40.4%,respectively. Medical students of different genders, nationalities, majors and age had different levels of environmental and health literacy and three types of classification literacy, all of which showed that the rate of boys were higher than girls, the rate of han students were higher than minority students, the rate of preventive medicine students were higher than that of other majors, and an increasing trend was found with the increase of age(P<0.05).The environmental and health literacy level and basic concept literacy level of medical students at different professional levels also showed an increasing trend(P<0.05). Multivariate Logistic regression analysis showed that the factors affecting medical students’ environment and health literacy included gender, nationalities, majors and professional levels(OR=0.68, 0.66, 0.30-2.83, 0.18, P<0.05). Conclusion The environmental and health literacy of medical students are generally low, especially in terms of basic knowledge of environment and health. Comprehensive health education regrading environment and health literacy should be carried out in colleges to increase awareness and knowledge among future education leaders.

OBJECTIVETo investigate the prevalence of transfusion-transmitted virus (TTV) and human papillomavirus (HPV) co-infection in cervical smears of patients with cervical lesions in littoral of Zhejiang province and analysis of transmitted route.

METHODSNested polymerase chain reaction (nPCR) was established. TTV DNA were tested by nPCR in cervical smears of 95 patients with cervical lesions and 55 healthy women, paired serum samples were available from 55 and 42 women, and their viral titer. The genotypes of 95 specimens of cervical cytology were detected with HybriMax. The phylogenetic group of TTV was determined by means of nPCR with N22 primers.

RESULTSThe prevalence of TTV DNA in cervical smears of patients with cervical lesions and healthy women was 52.7% (29/55) and was comparable with that in paired serum sample (50%). Symptomatic women had significantly higher prevalence of TTV DNA in cervical smears (74.7%) than healthy controls (P = 0.005). The TTV DNA prevalence in patient serum samples was 51%. The phylogenetic groups of TTV serum isolates were concordant with those of TTV from cervical smears of the same subjects, and genotype was G1b. The TTV viral titer in cervical smears were 10 to 1000 times as high as in serum. The total infection rate of HPV was 98.9% in patients, and was 27.3% in healthy women. The frequently detected genotype was HPV16, 18, 33 of HSIL, and HPV6 of LSIL. The HPV positive study subjects had significantly higher TTV DNA prevalence than HPV negatives (P = 0.02).

CONCLUSIONHigh prevalence of TTV in cervical smears suggests that sexual transmission is another mode of expansion of TTV infection among the population. The higher viral titer in cervical smears than in the respective serum samples might indicate active TTV replication in the female genital tract. Nevertheless, cooperation between TTV and HPV needs to be further investigated.

Adolescent ; Adult ; DNA Virus Infections ; complications ; epidemiology ; virology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; complications ; epidemiology ; virology ; Polymerase Chain Reaction ; Torque teno virus ; physiology ; Uterine Cervical Diseases ; epidemiology ; virology ; Vaginal Smears ; Young Adult

In order to evaluate the effect of omega-3 fish oil supplement by gavage (0.4 mL/100 g body weight) on the chronic lead-induced (0.2% lead acetate) impairments of long-term potentiation (LTP) in rat dentate gyrus (DG) in vivo, we designed the experiments which were carried out in four groups of newborn Wistar rats (the control, the lead-exposed, the control with fish oil treatment and the lead-exposed with fish oil treatment, respectively). The excitatory postsynaptic potential (EPSP) and population spike (PS) amplitude were measured in the DG of rats with above different treatments at the age of 80-90 d in response to stimulation applied to the lateral perforant path. The results showed (1) postnatal chronic lead-exposure impaired LTP measured on both EPSP slope and PS amplitude in DG area of the hippocampus; (2) in the control rats, omega-3 fish oil had no effect on LTP while in the lead-exposed rats, omega-3 fish oil had a protective effect on LTP. These results suggest that omega-3 fish oil supplement could protect rats from the lead-induced impairment of LTP. Omega-3 fish oil might be a preventive substance in reducing LTP deficits induced by lead.
Animals ; Animals, Newborn ; Dentate Gyrus ; drug effects ; Excitatory Postsynaptic Potentials ; Fatty Acids, Omega-3 ; pharmacology ; Fish Oils ; chemistry ; Lead Poisoning ; physiopathology ; Long-Term Potentiation ; drug effects ; Perforant Pathway ; Rats ; Rats, Wistar

OBJECTIVETo study the clinical effect of arthroscopic excision of popliteal cysts through a combined anterior and posterior approach.

METHODSFrom January 2010 to December 2012,20 patients with popliteal cysts were treated with arthroscopic excision. There were 14 males and 6 females, with an average age of 49.5 years old, ranging from 45 to 65 years old. The lump has been found for 4 to 18 months,with a mean time of 12 months. Their mean sagittal diameter was 4.5 cm (ranged from 3 to 7 cm). There were 12 popliteal cysts in the left and 8 popliteal cysts in the right. The main clinical manifestation included lump at popliteal fossa, swelling and pain at knee joint and some extent of dysfunction. All diagnoses were determined according to MRI, which clearly showed the communication of cyst and articular cavity. The cyst was removed under arthroscopy, through the posterior approach and then the intra-articular lesion was treated via the anterior approach. According to Rauschning and Lindgren classification, 2 patients were grade I, 6 patients were grade II, and 12 patients were grade III. The guidelines of Rauschning and Lindgren were used to evaluate the clinical effects.

RESULTSNo complications such as the injury of blood vessel and nerve, or incision infection occurred in all patients. All the patients were followed up, and the duration ranged from 8 to 24 months, with a mean time of 16 months. According to the criteria of Rauschning and Lindgren, there were 14 cases of grade 0, and 6 cases of grade I after operation, which was improved obviously compared with that pre-operation. No cyst reoccurred and the knee joint pain was relieved.

CONCLUSIONTreatment of popliteal cysts with arthroscopic excision through a combined anterior and posterior approach is effective to remove the cyst sac and treat intra-articular diseases simultaneously, resulting in the decrease recurrence rate of cyst.

Aged ; Arthroscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Popliteal Cyst ; surgery

Objective To establish the condition cultrue cell system and co-culture cell system with SKOV3/PM4,HUVEC and to study the changes of their biological characteristics. Methods The cells of SKOV3/PM4 and HUVEC were labeled with green and red fluorescent respectively. The cell supernatant of SKOV3/PM4 and HUVEC were collected respectively as the condition medium(e.g:the cell supernatant of HUVEC cells was used as SKOV3/PM4 condition medium)and to establish the condition cultrue cell system and the co-culture cell system of the two cell lines. In the condition cultrue cell system, The morphological changes of cells were observed by HE staining to calculate the mitotic index. The ultrastructural changes of the two cells were observed by transmission electron microscopy(TEM). The growth curve of the cells was determined by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry was used to analyzed the cell cycles.In the co-culture cell system, the interaction of the two cells were detected by laser scanning confocal microscope(LSCM). The expression of matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) were detected by gelatin zymography. Results Compared with the single culture SKOV3/PM4, the cells which cultured in HUVEC condition medium showed the increase of pseudopodia and nuclear division,the mitotic index respectively were [(4.8 ± 0.8)%,(11.2 ± 0.3)%;P<0.05]. The growth rate was significantly increased. In cell cycles, it showed the declined cell ratio of G0/G1 phase, respectively[(69.4±3.6)%, (48.4±4.6)%;P<0.05] and the raised cell ratio of G2/M phase, respectively [(5.2±1.6)%, (24.9±2.2)%;P<0.05]. Compared with the single culture HUVEC,the cells which cultured in SKOV3/PM4 condition medium showed the significant morphological change and vacuolization in the cytoplasm, Nuclear division was increased and the mitotic index respectively were [(2.7±0.5)%, (5.7±0.6)%;P<0.05]. The growth rate was slightly declined. In cell cycles, it showed the raised cell ratio in G0/G1 phase, respectively [(51.4 ± 2.2)%,(79.0 ± 4.1)%;P<0.05] and the declined cell ratio in G2/M phase, respectively [(19.1±1.2)%, (3.3±0.5)%;P<0.05]. After co-culture for 48 hours, spontaneous fusion between SKOV3/PM4 and HUVEC cell was observed by the laser confocal microscope. Gelatin zymography assay showed that MMP-2 was not expressed in HUVEC cells, low-expressed in SKOV3/PM4 cells and high-expressed in the co-culture SKOV3/PM4+HUVEC cells. The expression of MMP-2 in co-culture SKOV3/PM4+HUVEC cells and SKOV3/PM4 cells respectively were 1 885 ± 84 and 1 209 ± 114 (P<0.05). But there were no MMP-9 expression in HUVEC cells, SKOV3/PM4 cells, and the co-culture SKOV3/PM4+HUVEC. Conclusion The characteristics of SKOV3/PM4 and HUVEC show significant changes after condition culture and co-culture, it may involve in the microenvironment of the cells and the intercellular crosstalk pathway.

OBJECTIVETo discuss application of structural equation model (SEM) approach in epidemiological research.

METHODSA brief overview on major components of SEM, statistical assumptions underlying the use of SEM, and current software available to users and how SEM can be used were discussed through a practical epidemiological research project.

RESULTSAdvantages of SEM comparing with conventional epidemiological approach were shown. SEM, having the nature of comprehensive thinking and analytic approach, not only exploring the association between factors and diseases but also among factors. It also served a confirmatory, rather than exploratory approach on data modeling, as well as having the capability of correcting estimates by separating measurement error from the equations, to provide modeling the latent variables.

CONCLUSIONSEM approach could be used in epidemiological research as having some advantages comparing with conventional epidemiological approaches.

Epidemiologic Methods ; Epidemiology ; Factor Analysis, Statistical ; Humans ; Models, Biological ; Research Design

The aim of this study was to construct the eukaryotic expression vectors harboring human vWF-A1A2A3 gene and to investigate its expression in CHO cells and biologic function so as to provide a basis for further exploring the biologic activity of vWF-A1A2A3. The primers were designed according to published sequences; the human vWF-A1A2A3 was amplified by PCR from vWF cDNA; the fragment of interest was inserted into eukaryotic expression vector pSectag2b by using restriction enzyme and ligase after vWF-A1A2A3 was confirmed by sequencing. The recombinant expression plasmid was transfected into CHO cells and the stable expression product (rvWF-A1A2A3) was detected by using Western blot. The results showed that the eukaryotic expression vector pSectag2b-A1A2A3 was successfully constructed and expressed its corresponding protein efficiently. The recombinant protein was identified to be able to bind collagen and ristocetin-induced platelets. It is concluded that the pSectag2b-A1A2A3 is successfully constructed and can express in CHO cells. The rvWF-A1A2A3 protein established in this study provides a basis for the further study on its biological structure, function and clinical application.
Animals ; CHO Cells ; Cloning, Molecular ; Cricetinae ; Cricetulus ; Gene Expression ; Genetic Vectors ; Humans ; Plasmids ; Recombinant Proteins ; genetics ; Transfection ; Trinucleotide Repeats ; von Willebrand Factor ; genetics