Objective:This paper investigates the difference of chronic disease in different social class of the elderly in Beijing .Method: Date of a representative sample included 1717 residents aged 60 and above are drawn from Beijing elderly household survey 2013 conducted by Peking university school of public health .With income , ed-ucation , occupation and residence household as indicators of social class , logistic regression model is used for analy-zing the difference of chronic disease prevalence among different socio-economic status .Result:The non-agricultural household group , middle and highest income group , the least and highest groups of education have a lower probability and the farming , forestry, animal husbandry and fishing water production personnel before retired have a higher risk of suffering from chronic disease .In terms of multiple chronic diseases , second lowest 20%income group tie to high-er risk of suffering three or more chronic conditions simultaneously .Conclusion: Strategies development of chronic disease prevention and control should take full account of social determinants of health such as the social stratifica -tion , not just for the direct cause of chronic diseases .Agricultural household , low-income and low-education group of people should be priorities in Beijing elderly chronic disease prevention and control .

Objective To investigate the role of mucosal mast cells infiltration and degranulation with nerve growth factor (NGF)in development of visceral hypersensitivity in Sprague-Dawley (SD)rats. Methods The model of visceral hypersensitivity of irritable bowel syndrome (IBS)was established in 19 neonate SD rats with intestinal stimulation (rectalballon distention)on 8th,10th and 12th postnatal days. The other 19 neonate SD rats without colonic distention were assigned to the control group.After rats grew up (six to eight weeks old),the visceral sensitivity was tested by abdominal withdrawal reflex (AWR)in 10 rats of each group.Mast cell infiltration and degranulation were observed with toluidine blue staining in colon tissue slides.The NGF level of intestinal tissues was detected by enzyme-linked immunosorbent assay (ELISA)methods in the left nine rats of each group.The culture system of dorsal root ganglias (DRG)from the neonatal rats was set up.The changes of electrophysilogical characters of DRG stimulated with NGF (100 ng/mL)for four days were recorded with patch-clamp.Paired t test was performed for comparison between groups.Results The results of AWR indicated that neonatal colonic stimulation could significantly increase visceral sensitivity after growing up.Under 20,40 and 60 mmHg (1 mmHg=0.133 kPa)distention pressure,visceral sensitivity scores of visceral hypersensitivity rats and rats of control group were 1 .00±0.50 vs 1 .67 ±0.50,1 .89 ±0.31 vs 2.89 ±0.34 and 2.89 ±0.33 vs 3.89±0.33,the differences were statistically significant (t=-2.83,-6.00 and -6.00,all P <0.05 ). The results of master cells staining in tissue slides showed colonic master cells infiltration was obvious in rats with visceral hypersensitivity,and part of mast cells were degranulation.The result of ELISA demonstrated that NGF level of visceral hypersensitivity rats was significantly higher than that of control group ((11.07±3.06)pg/mg vs (2.38 ±1.88)pg/mg,t =-6.93,P <0.05).The results of electrophysilogical tests of primary cultured DRG indicated that compared with blank control growp,the action potential threshold of neuron in NGF 100 ng/mL group significantly decreased ((-18.0±2.1 )mV vs (-29.0 ± 2.5 )mV,t = 12.26,P <0.05)and discharge frequency increased ((5 .0± 1 .4 )/800 ms vs (12.0 ± 3.2)/800 ms,t=-8.40,P <0.05 ).Meanwhile,neuron voltage-gated K+ current density remarkably decreased,most were sustained delayed rectifier K+ current (I K )decreasing ((279.0 ±48.0)pA/pF vs (203.0±39.0)pA/pF,t=6.18,P <0.05).Conclusion Colonic stimulation in neonatal rats could cause intestinal master cells infiltration and degranulation,which induced changes of neuron electrophysilogical characters and resulted in visceral hypersensitivity after growing up.

Objective To analyze the prevalence of Clostridium difficile infection (CDI) in patients with inflammatory bowel disease (IBD) accompanied with diarrhea in order to analyze the possible risk factors and its impact on short-term prognosis.Methods From January 2013 to June 2015,a total of 169 IBD patients with diarrhea who visited Rui Jin Hospital,School of Medicine,Shanghai Jiaotong University were enrolled,and in the same period 184 non-IBD patients with diarrhea were enrolled as control group.Clinical data of IBD patients with diarrhea were collected.Clostridium difficile toxins A and B of stool specimens of all included patients were detected with enzyme immunoassay.T test,chi-square test and logistic regression analysis were performed for statistical analysis.Results Among 169 IBD patients with diarrhea,there were 137 adults and 32 children.The positive rate of CDI of IBD patients with diarrhea (9.5％,16/169) was higher than that of non-IBD patients with diarrhea (1.1％,2/184),and the difference was statistically significant (x2 =12.785,P ＜ 0.0l).The positive rate of CDI in adults and children with IBD accompanied with diarrhea were 7.3％ (10/137),and 18.8％ (6/32),respectively.Among 16 CDI-positive IBD patients with diarrhea,10 patients had hospitalization history before admission,and the rate of previous hospitalizations was higher than that of CDI-negative IBD patients with diarrhea (37.3％,57/153),and the difference was statistically significant (x2 =2.875,P =0.01,odds ratio (OR) =1.26,95％ confidence interval (CI) 0.78 to 2.03).Furthermore,among 16 CDI-positive IBD patients with diarrhea,14 patients had been treated with antibiotic drugs before,the antibiotic utilization rate was higher than that of CDI-negative IBD patients with diarrhea (34.6％,53/153),and the difference was statistically significant (x2 =14.778,P ＜ 0.01,OR =24.74,95％ CI 3.15 to 194.46).However,there was no statistically significant difference in the length of hospitalization,incidence of bowel surgery and usage of inflaximab within six months after Clostridium difficile detection between the CDI-positive group and CDInegative group of 1BD patients with diarrhea (all P ＞ 0.05).Conclusions The incidence of CD1 in IBD patients with diarrhea increases.The risk factors include history of previous hospitalization before admission and antibiotic usage.However there is no significant correlation between CDI and short-term prognosis of IBD.

Objective:To investigate the efficacy and safety of polatuzumab vedotin (pola) in treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 1 DLBCL patient receiving multiple treatments in Jiangsu Cancer Hospital in May 2016 were retrospectively analyzed, and the related literature was reviewed.Results:The patient, a 57-year-old male, was diagnosed with DLBCL in May 2016. Since June 2016, he had received treatments with four lines including anti-CD20 monoclonal antibody combined with chemotherapy, chemotherapy only and chimeric antigen receptor T cell (CAR-T). However, the disease relapsed or progressed after all treatments. Therefore, the patient had received 6 cycles of pola combined with rituximab since December 2019. Unexpected adverse events were not found during the treatment. The evaluation of clinical efficacy was complete remission after the end of treatment. The progression-free survival time was more than 13 months with follow-up until January 2021.Conclusion:Pola initially shows good efficacy and safety in treatment of patients with relapsed/refractory DLBCL.

Objective To investigate the mechanism of TNF-related apoptosis-inducing ligand (TRAIL) promoting apoptosis of pancreatic cancer cells SW1990, Patu8988 and BxPC3. Methods Three kinds of pancreatic cancer cells SW1990, Patu8988 and BxPC3 were transfected with the pCA13 plasmid carrying TRAIL gene ( pCA13 TRAIL group) and the blank plasmid control ( pCA13 group) , respectively. The expression of TRAIL mRNA in transfected cells was detected by RT-PCR, and the expression of TRAIL protein was detected by Western blot. The apoptosis rate and expression of TRAIL receptor R1 and R2 were detected by flow cytometry. Apoptosis was detected by TUNEL and Hoechst double staining, and observed by electron microscopy. The expression of caspase-3 in transfected cells was detected by immunohistochemistry. Results SW1990, Patu8988 and BxPC3 cells can expresse TRAIL mRNA and protein within 24 h after transfection. The apoptotic rate at 24 h after transfection was (27. 30 ± 5. 14)％, (13. 52 ± 0. 95)％ and (31. 40 ± 8. 70)％,respectively, which was higher than that of pCA13 group [(10. 58 ± 1. 88)％,(8. 42 ± 0. 46)％ and (16.11 ±1.66)％], respectively. The expression rates of TRAIL-R1 were (61.37 ± 3.05)％,(42.10 ± 5. 11)％ and (36. 64 ± 4. 84)％, respectively, and the expression rates of TRAIL-R2 were (36. 20 ± 4. 83)％,(37. 26 ± 8. 46)％ and (24. 32 ± 3. 71)％, respectively,which were higher than those of pCA13 group except PATU8988 cells. Positivity rates of caspase-3 were ( 14. 64 ± 5. 35 )％, ( 9. 92 ± 5. 50 )％ and (16. 12 ± 6. 74)％, which were obviously higher than ( 3. 01 ± 1. 50 )％, ( 1. 75 ± 0. 50 )％ and ( 3. 79 ± 1. 58)％ in pCA13 group,and the differences were statistically significant(P<0. 05). Conclusions TRAIL could up-regulate the expression of TRAIL R1 and R2 in multiple pancreatic cancer cell lines in vitro, and thus promote cell apoptosis.

Objective: To investigate whether it can reduce the incidence of pressure ulcer caused by ICU equipment, when nurses in ICU use the SKIN model framework to carry out preventive and nursing measures. Methods: To construct the teaching group of nursing workshop based on SKIN mode for preventing pressure ulcer caused by ICU equipment and train 36 ICU nurses. Before and after training course, to collect the behaviors of preventing pressure ulcer caused by ICU equipment during clinical work time and the incidence and severity of pressure ulcer. Results: The nurses′ behaviors of controlling skin status of patients who use Bi-level positive airway pressure non-invasive mask and evaluating nutritional status of patients change a lot (χ²=34.420,10.123, P <0.01). The nurses′ behaviors of checking and evaluating skin status of patients who have stomach tube to reduce skin pressure, shear and friction and assessing nutritional status of patients were improved (χ²=7.547-49.451, P <0.05). The nurses′ behaviors mentioned above of nursing patients who have oral air tube were also changed significantly (χ²=5.225, 23.402, 12.444, P<0.05 or 0.01). The incidence of pressure ulcer caused by ICU equipment dropped from 2.86%(100/3 502) to 1.87%(67/3 580) (χ²=7.445, P<0.05). The decrease in incidence of Ⅱand Ⅲ grade pressure ulcer are from 48%(48/100) to 22.39%(15/67) and 34%(34/100) to 7.46%(5/67) respectively and had significant differences as well (χ²=11.202, 15.784, P<0.01). Conclusions This study explains the training approach based on SKIN mode of prevention of pressure ulcer caused by ICU equipment. The results show that the training approach can decrease the incidence and severity of pressure ulcer caused by ICU equipment, improve the nurses′ nursing behaviors and promote the transform of theory related to pressure ulcer from basement to clinical reality.