Objective To study the ages at natural menopause of the women in Jilin Province, and to illustrate its influencing factors among the women in Jilin Province.Methods Through multistage stratified cluster random sampling method,23 050 people aged from 18 to 79 years were drew from nine states(a total of 32 areas)of Jilin province.The data of these residents were collected with the questionnaire and physical examinations by face-to-face interview.The number of selected female sample was 11 098. Finally, 4 881 postmenopausal women were selected.Complex weighted computation was used to estimate the ages at natural menopause.One-way ANOVA was used to compare the ages at natural menopause of the women with different birth years. Multiple linear regression analysis were used to examine the influencing factors of the ages at natural menopause. Results The mean and median ages at natural menopause were (49.11±4.19)years and 50.00 years,respectively.There were 4 881 cases of postmenopausal women,among them the women with age at natural menopause<40 years,40 year≤age at natural menopause≤45 years,46 years≤ age at natural menopause≤53 years,age at natural menopause≥54 years and age at natural menopause missing accounted for 2.27%(111 cases),13.17%(643 cases),71.97%(3 513 cases),11.74% (573 cases),and 0.85%(41 cases),respectively.Converted to birth years by age,70-79 years old was 1933-1942 birth years,60-69 years old was 1943-1952 birth years and 57-59 years old was 1953-1955 birth years.The age at natural menopause in Jilin province was statistically significant among the women with different birth years(F=21.178,P<0.001).By SNK-q test among three different birth year groups, the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.38 years,49.51 years and 48.81 years.The age at natural menopause in urban of Jilin province was statistically significant among the women with different birth years(F=16.633,P<0.001).By SNK-q test among three different birth year groups,the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.77 years,49.73 years,and 48.85 years,respectively.The age at natural menopause in rural of Jilin province was statistically significant among the women with different birth years(F=7.400,P=0.001 ). By SNK-q test among three different birth year groups, the age at natural menopause was different between 1953-1955 birth year group and the other two groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.09 years,49.33 years,and 48.74 years,respectively.The multiple linear regression results indicated that BMI and exercise were positively correlated with the age at natural menopause,but smoking and mental health evaluation were negatively.Consumption frequency of vegetables,fruits,bean products,and meat was no correlated with the age at natural menopause.Conclusion The differences of the ages at natural menopause between the women with different birth years are statistically significant in Jilin Province;BMI, smoking, exercise,and mental health are the influencing factors of the age at natural menopause.

Objective To investigate the characteristics of the bone marrow mesenchymal stem cell(MSC)in children with aplastic anemia(AA)in vitro,and the expressions of tumor necrosis factor -α-induced protein -8 -like 2(TIPE2)in the bone marrow,and the correlation between the level of TIPE2 mRNA with γ-interferon(IFN -γ)and IL -6 in AA patients.Methods Bone marrow samples were collected from 1 8 children with AA(AA group)and 8 children with bone injury (control group)who were hospitalized in Jinan Children′s Hospital from January 201 2 to June 201 5.MSC were isolated and cultured.The morphology of MSC was observed and immune phenotype was detected.The TIPE2 mRNA was detected by using real -time fluorescence quantitative PCR,and the levels of IFN -γand IL -6 were detected by using enzyme linked immunosorbent assay.Results Different sizes had been presented in the primi-tive MSC of AA patients,but the third passage MSC until 80% confluence had manifested the uniform convergence with long spindle and swirl distribution.In the sixth passage,cells showed degenerative change.The primitive and first pa-ssage MSC in patients with AA was longer than that in the controls.CD73 ,CD1 05 ,CD44 and CD90 were expressed in MSC,while CD34 ,CD45 ,CD271 expressed rarely.The level of TIPE2 mRNA in AA patients (5.29 ±1 .56)was obviously lower than that of the control group(8.68 ±2.00),and the difference was significant(t =-4.48,P <0.01 ).The con-centration of IFN -γ[(5.48 ±1 .97)ng/L]and IL -6[(5.43 ±1 .92)ng/L]in AA patients were higher than those of the control group[(3.40 ±1 .24)ng/L,(3.79 ±0.92)ng/L],and the differences were significant (t =2.70, 2.26,all P <0.05).The level of TIPE2 mRNA in AA patients was negatively related with IFN -γand IL -6(r =-0.838,-0.658,all P <0.05),but there was no significant correlation between them in the control group (all P >0.05).Conclusions The proliferation of MSC is significantly reduced in patients with AA.TIPE2,as an important role to stabilize the immune system,plays an important role in the occurrence of AA by its low expression and up -regula-ting the expression of inflammatory factors.

Objective To investigate the influence of early growth response gene-1 (EGR1) on the autophagy of host cells following infection with human T cell leukemia virus type 1 (HTLV-1).MethodsA HTLV-1-positive cell line MT2 was co-cultured with HeLa cells for 24 h to construct the virus early infection model.Immunoblotting assay was used to detect the expression of HTLV-1 core protein p19 and EGR1.Luciferase reporter gene analysis was used to detect the transcriptional activity of 5′-regulatory sequence of EGR1 at different time points after co-culturing.An effective small interfering RNA (siRNA) targeting EGR1 was screened out and transfected into HeLa cells by Lipofectamine 2000.Then the transfected HeLa cells were co-cultured with the HTLV-1-positive cell line MT2 for 24 h.Immunoblotting assay was used to detect HTLV-1 core protein p19, EGR1 and autophagy-related protein LC3.Real-time PCR was performed to detect viral load.Autophagosome was analyzed by immunofluorescence after co-culturing.Results The expression of EGR1 and the transcriptional activity of pEGR1-luc gradually increased after co-culturing HeLa cells with MT2 cells for 8 h (P<0.01).The expression of EGR1 was positively correlated with host cell autophagy following HTLV-1 infection.The effective siRNA for silencing the expression of EGR1 was obtained and named as siE2.The viral load, the expression of HTLV-1 core protein p19 and the proportion of LC3B/LC3A in the co-culture model were markedly down-regulated by RNA interference with siE2, which was concomitant with a persistent decrease of intracellular autophagosome (P<0.01).Conclusion EGR1 is associated with host cell autophagy and viral replication in HTLV-1 infection.

Objective To understand the prevalence of goiter and nodule as well as the iodine nutritional status of 8 to 10 years old children after changing water source with lower iodine so as to evaluate its intervention effectiveness.Methods From 2014 to 2017,Machang Village and Liangzhang Village of Haixing County in Haixing County were selected as monitoring sites in the water-sourced high iodine area in Hebei Province.Using the cross-sectional survey method,100 children aged 8 to 10 years old were randomly selected in each village,half male and half female.Dynamic monitoring of drinking water iodine content,children's prevalence of goiter and nodule as well as urinary iodine content were conducted before and 1-3 years after changing water resource.Iodine detection was performed using an arsenic cerium-catalyzed spectrophotometric method suitable for iodine-deficient and high-iodine areas (recommended method for national iodine deficiency disease reference experiment);urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).The thyroid test was performed using the B-ultrasound method and the criterion was based on the "Diagnostic Criteria for Endemic Goiter" (WS 276-2007).Results The median iodine content of water in the two villages before the reformation was 861.0 μg/L,and it was 71.6,29.1 and 30.4 μg/L in 1-3 years after water was changed.The overall difference before and after water change was statistically significant (x2 =8.48,P ＜ 0.05).The median urine iodine of children in the two villages before the change of water was 705.0 μg/L,and the median urine iodine of children was 306.0,143.0 and 140.0 μg/L after 1-3 years.The differences were statistically significant (Z =6.56,10.82,11.19,P ＜ 0.05).The goiter rate was 10.3％ (21/203) before changing water,and the goiter rate was 6.3％ (13/205),6.4％ (13/203) and 3.8％ (8/208) in 1-3 years after water exchange,and the difference between before and 3 years after water exchange was statistically significant (x2 =6.61,P ＜ 0.05).Children's nodule prevalence before and 3 years after changing water was 11.3％ (23/203) and 1.4％ (3/208),the difference was statistically significant (x2 =13.42,P ＜ 0.05).Conclusion Three years after changing water resource,children's goiter prevalence is back to normal in general,and nodule prevalence is decreased significantly,which indicates sound intervention effectiveness.

Objective To investigate the survival of oral arsenic-containing Qinghuang Powder (QHP) and low intensive chemotherapy (LIC) in the treatment of elderly patients with acute myeloid leukemia (AML).Methods Forty-two AML patients older than 60 years in Xiyuan Hospital from January 2015 to December 2017 were retrospectively analyzed.Of them,20 cases were treated with QHP (QHP group),22 cases were treated with LIC (LIC group).The survivals of the two groups were compared.Results There was no significant difference of median survival time (13 months vs.13.5 months,x2 =0.096,P =0.757),1-year survival rates (59.1％ vs.70.0 ％,x2 =0.543,P =0.461),2-year survival rates (13.6 ％ vs.15.0 ％,x2 =0.016,P ＞ 0.05),and 3-year survival rates (4.6 ％ vs.5.0 ％,x2 =0.005,P ＞ 0.05) between LIC and QHP groups.There was no significant difference of median survival time in age ≥75 year (12 months vs.12.5 months,x2 =1.317,P =0.251),performance status scores ＞ 2 (12 months vs.12 months,x2 =0.834,P =0.361),hematopoietic stem cell transplantation with combined disease index ＞ 2 (12 months vs.13 months,x2 =1.726,P =0.189),secondary AML (10 months vs.14 months,x2 =1.552,P =0.213),and poor cytogenetics (12 months vs.8 months,x2 =0.479,P =0.489) between LIC and QHP group.Conclusion The survival of elderly AML patients is considerable in patients treated with oral QHP and LIC,which suggests that oral QHP may be an equivalent alternative treatment since elderly AML (especially more than 75 years) patients refused to LIC therapy.

OBJECTIVE: To detect germline mutation in a pedigree affected with familial renal cell carcinoma and explore its molecular pathogenesis. METHODS: Peripheral blood samples from the patients and her family members were collected for the extraction of genomic DNA. Sanger sequencing, real-time quantitative PCR and reverse transcriptase-PCR (RT-PCR) were carried out to detect single base mutation, small insertion and deletion, and large fragment deletion of the VHL gene. RESULTS: Real-time quantitative PCR combined with sequencing of RT-PCR product showed that there was a single-copy deletional germline mutation in exon 2 of the VHL gene in the proband. CONCLUSION Loss of heterozygosity in exon 2 of the VHL gene probably underlay the etiology of familial renal cell carcinoma in this pedigree. Screening for germline mutations of the VHL gene can effectively predict the prognosis of individual patients.

Objective:To investigate the expression of IGF1R-Ras and RAGE-HMGB1 signaling pathways in colorectal cancer patients with type 2 diabetes mellitus and their significance.Methods:The resected cancer tissues were obtained from 59 patients with colorectal cancer (CRC), including 29 patients with type 2 diabetes mellitus (CRC/DM group) and 30 with CRC alone (CRC group). The expressions of IGF1R, Ras, RAGE and HMGB1 in cancer tissues were detected by immunohistochemistry. The differences between the two groups were compared and the relationship between the expression and clinicopathological characteristics was analyzed.Results:In CRC/DM group, the positive rates of IGF1R and Ras were both 65.5% (19/29), and 51.7% (15/29) patients had IGF1R+ Ras+ immunophenotype, which were significantly higher than those in CRC group [33.3% (10/30), 36.7% (11/30) and 20.0% (6/30); P=0.013, 0.027 and 0.011, respectively]. The expression of IGF1R and Ras in CRC / DM group was positively correlated ( r=0.479, P=0.017). The positive rate of RAGE expression in CRC group and CRC/DM group was 70.0% (21/30) and 72.4% (21/29) respectively, and the positive rate of HMGB1 expression was 46.7% (14/30) and 58.6% (17/29) respectively, neither was observed with significant difference ( P=0.358 and 0.838). However, the proportion of patients with RAGE+ HMGB1+ immunophenotype in CRC/DM group [55.2% (16/29)] was higher than that in CRC Group [26.7% (8/30)] which was statistically significant ( P=0.026), and the expression of both proteins was positively correlated in CRC/DM group ( r=0.578, P=0.003). The clinicopathological analysis showed that in both groups the expression of IGF1R, Ras, RAGE and HMGB1 had no correlation with the sex, age, differentiation degree, tumor length, T stage and lymph node metastasis ( P>0.05). Conclusion:Both IGF1R-Ras and RAGE-HMGB1 pathways may be involved in the oncogenesis of colorectal cancer in patients with type 2 diabetes.

Objective:To explore the impact of multimorbidity on disability in older adults, providing a reference for formulating strategies for the management and nursing of multimorbidity and disability in older adults.Methods:Adopting the method of cross-sectional survey research, the data of 6 469 older adults (≥60 years old) were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey database in July 2023, including basic information, chronic disease prevalence, and disability measured by basic activities of daily living (BADL), and instrumental activities of daily living (IADL). They were divided into multimorbidity and non-multimorbidity groups based on whether they had two or more chronic diseases. The propensity score matching (PSM) method was used to match the basic conditions of the two groups of older adults with the proportion of 1∶1. Binary logistic regression was applied to analyze the effects of multimorbidity on BADL disability and IADL disability.Results:Among 6 469 older adults, there were 2 882 males and 3 582 females, with 3 158 aged 60-84 years old and 3 311 aged over 84 years old. BADL disability accounted for 26.5% (1 712/6 469), while IADL disability accounted for 66.8% (4 324/6 469). There were 2 335 patients in the multimorbidity group and 4 134 patients in the non-multimorbidity group. Binary Logistic regression analysis showed that the risk of BADL disability in older adults in multimorbidity group was 1.511 times higher than that in the non-multimorbidity group (95% CI 1.317-1.734, P<0.01); the risk of IADL disability in older adults in the multimorbidity group was 1.618 times higher than that in the non-multimorbidity group (95% CI 1.426-1.835, P<0.01). Conclusions:Multimorbidity would increase the risk of disability in older adults. Relevant authorities should develop relevant interventions and nursing responses to enhance the prevention and management of multimorbidity and disability in older adults.

Objective:To investigate the expression of IGF1R-Ras and RAGE-HMGB1 signaling pathways in colorectal cancer patients with type 2 diabetes mellitus and their significance.Methods:The resected cancer tissues were obtained from 59 patients with colorectal cancer (CRC), including 29 patients with type 2 diabetes mellitus (CRC/DM group) and 30 with CRC alone (CRC group). The expressions of IGF1R, Ras, RAGE and HMGB1 in cancer tissues were detected by immunohistochemistry. The differences between the two groups were compared and the relationship between the expression and clinicopathological characteristics was analyzed.Results:In CRC/DM group, the positive rates of IGF1R and Ras were both 65.5% (19/29), and 51.7% (15/29) patients had IGF1R+ Ras+ immunophenotype, which were significantly higher than those in CRC group [33.3% (10/30), 36.7% (11/30) and 20.0% (6/30); P=0.013, 0.027 and 0.011, respectively]. The expression of IGF1R and Ras in CRC / DM group was positively correlated ( r=0.479, P=0.017). The positive rate of RAGE expression in CRC group and CRC/DM group was 70.0% (21/30) and 72.4% (21/29) respectively, and the positive rate of HMGB1 expression was 46.7% (14/30) and 58.6% (17/29) respectively, neither was observed with significant difference ( P=0.358 and 0.838). However, the proportion of patients with RAGE+ HMGB1+ immunophenotype in CRC/DM group [55.2% (16/29)] was higher than that in CRC Group [26.7% (8/30)] which was statistically significant ( P=0.026), and the expression of both proteins was positively correlated in CRC/DM group ( r=0.578, P=0.003). The clinicopathological analysis showed that in both groups the expression of IGF1R, Ras, RAGE and HMGB1 had no correlation with the sex, age, differentiation degree, tumor length, T stage and lymph node metastasis ( P>0.05). Conclusion:Both IGF1R-Ras and RAGE-HMGB1 pathways may be involved in the oncogenesis of colorectal cancer in patients with type 2 diabetes.

Objective:To explore the cognition, recognition and knowledge needs of the parents of outpatient children with aerosol inhalation therapy, so as to provide a reference for the development of effective health education and improve the nursing satisfaction of the parents of the children.Methods:This study was a cross-sectional study. From March 2020 to March 2021, convenience sampling was used to select 260 parents of children who were treated with aerosol inhalation therapy in the Pediatric Clinic of the Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University as the research subject. The self-made Aerosol Inhalation Therapy Related Knowledge Questionnaire was used to investigate the parents.Results:A total of 260 questionnaires were issued, and 243 valid questionnaires were returned with the valid response rate of 93.5%.The total cognitive score of aerosol inhalation therapy of the parents of children was (50.33±8.38) , and the total score of aerosol inhalation therapy attitude was (17.86±2.61) . A total of 31.7% (77/243) of the children 's parents believed that they needed knowledge about aerosol inhalation therapy very much, and 58.4% (142/243) of the children 's parents believed that they needed knowledge about aerosol inhalation therapy, and 67.9% (165/243) of the children 's parents preferred to obtain knowledge about aerosol inhalation therapy through face-to-face demonstrations. Conclusions:Parents of outpatient children have a high degree of recognition of aerosol inhalation therapy, and hope to get relevant knowledge and education. Nursing staff should mainly take face-to-face demonstrations, supplemented by videos and education manuals to carry out health education to parents of children, so as to improve the nursing satisfaction of parents of children.