Objective To study the life quality and influencing factors for empty nester elderly in rural area in Hunan,and to provide the scientific basis for the effective interventions.Methods The two villages of Yiyang and Huaihua were randomly selected by cluster sampling from June 2011 to December 2011 in Hunan.Data of the world health organizations quality of life instrument-short version (WHOQOL-BREF) was collected by face to face interview with the empty nesters.The risk factors for the quality of life in empty nester elderly in rural area were analyzed by the multiple linear regression analysis.Results A total of 785 valid questionnaires were acquired,among which 472 cases were from empty nester elderly (60.1％,472/785),the average age of them was (69.3±7.3) years,and the male:female ratio was 1.1:1 (250:222).The literacy of 81.8％ of empty nester elderly were under junior middle school,69.7％ of them married with consorts who were still living,74.4％ of them were farmer,75.2％ of them had monthly income under 500 Yuan,56.4％ of them got the income from their own labor,69.9％ of them considered that their relationship with children were harmony.64.2 ％ of empty nester elderly in village suffered from chronic diseases and 16.7 ％ of them suffered from accidental injury within the last one year.The scores in physiological health,psychological health and quality of life were lower in empty nester elderly than in the non-empty nester elderly [(60.8±15.7) vs.(63.1±13.5),(59.0±12.1) w (64.6±17.4),(59.5±9.8) vs.(63.0 ± 10.1),t=3.18,4.43,4.91,all P＜0.05].The multiple linear regression analysis showed that the influencing factors for quality of life in empty nester elderly were education background,marital status,source of finance,relationship with children,chronic disease and accidental injury within the last one year (β=1.693,2.426,0.779,1.060,-7.007,-3.784,all P＜0.05).Conclusions The empty-nest elderly accounts for more than half of the elderly in rural area,who have the lower levels in physio-psychological health and quality of life.We should improve their awareness and knowledge of health,build their harmonious relationship with spouse and children,improve the social security and medical insurance system,actively promote the knowledge of chronic disease and accidental injury,in order to improve the quality of life in empty nester elderly and achieve the healthy aging.

Objective:To develop a radiomics nomogram model based on CT to distinguish arteriovenous malformation(AVM) intracerebral hemorrhage from primary intracerebral hemorrhage.Methods:One hundred and thirty-five patients with cerebral hemorrhage confirmed by operation in the First Affiliated Hospital of Soochow University were analyzed retrospectively, including 52 patients with AVM cerebral hemorrhage and 83 patients with primary cerebral hemorrhage. Radiomics features were extracted from baseline CT, radiomics score (Radscore) was calculated and radiomic labels were constructed. Multiple logistic regression analysis was used for clinical features combined with CT signs to establish a clinical model. And then the nomogram model was generated according to the Radscore and the clinical model. The ROC curve and decision curve analysis (DCA) were used to evaluate the discrimination performance of the model.Results:Six features were selected and used to establish radiomic labels. The clinical model consisted of age (OR: 4.739, 95%CI 1.382-16.250) and hematoma location (OR: 0.111, 95%CI 0.032-0.385), while the nomogram model consisted of age, hematoma location and Radscore. In the training group, there was a significant difference between the nomogram model [area under curve (AUC) 0.912] and the clinical model (AUC 0.816), the radiomics model (AUC 0.857) ( Z=2.776, 2.034, P=0.006, 0.042, respectively); While in the validation group, there was no significant difference between the nomogram model (AUC 0.919) and the clinical model (AUC 0.788), the radiomics model (AUC 0.810) ( Z=1.796, 1.788, P=0.073, 0.074, respectively). DCA analysis showed that the clinical value of the nomogram model was superior to the clinical model and radiomic model. Conclusion:The radiomics nomogram can effectively distinguish AVM-related cerebral hemorrhage from primary cerebral hemorrhage, which is helpful for clinical decision-making.

Objective:To investigate the predictive efficacy of global inhomogeneity (GI) index based on pulmonary electrical impedance tomography (EIT) in postoperative pulmonary infection of patients with craniocerebral trauma.Methods:A total of 90 patients with emergency craniocerebral trauma underwent surgery under general anesthesia in Suzhou Science & Technology Town Hospital. According to the complication of pulmonary infection at the 3rd day after operation, they were divided into the pulmonary infection group (P3 group) and non-pulmonary infection group (NP3 group), and according to the complication of pulmonary infection at the 7th day after operation, they were divided into the P7 group and NP7 group. The average GI index within 5 min before anesthesia induction (T 0) and 5 min after endotracheal intubation (T 1) and other clinical data in the perioperative period were collected. The prevalence of pulmonary infection at the 3rd and 7th days after operation was recorded. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of preoperative GI index for pulmonary infection at the 3rd and 7th days after operation. Results:A total of 88 patients were included. Among them, 26 patients developed pulmonary infection within 3 days after operation, and the prevalence rate was 29.5%. Pulmonary infection occurred in 38 patients within 7 days after operation, and the prevalence rate was 43.2%. Within 3 days after operation, the preoperative Glasgow Coma Scale score in the P3 group was significantly lower than that in the NP3 group ( P < 0.05). Within 3 days after operation, GI index in the P3 group increased significantly at T 1 when compared with the NP3 group ( P< 0.001). Within 7 days after operation, GI index in the P7 group increased significantly at T 1 when compared with the NP7 group ( P < 0.05). GI index at T1 accurately predicted pulmonary infection within 3 days after operation (AUC = 0.857, P < 0.001), and the best intercept value was ≥0.4225 (sensitivity: 0.846, specificity: 0.823). GI index at T 1 predicted pulmonary infection within 7 days after operation (AUC = 0.667, P < 0.005), and the best intercept value was ≥0.4225 (sensitivity: 0.579, specificity: 0.780), but the prediction efficiency was poor. Conclusions:The average GI index within 5 min after endotracheal intubation can be used as an effective predictor of pulmonary infection within 3 days after operation.

Current studies have found that breast milk contains multiple growth factors with important biological functions, which play an important role in growth and immune regulation in early life.Epidermal growth factor(EGF)can promote the proliferation and differentiation of neonatal gastrointestinal mucosa epithelium, and can prevent the development of necrotizing colitis.Transforming growth factors(TGF)include transforming growth factor α and transforming growth factor β.Transforming growth factor α is related to gastrointestinal function, while transforming growth factor β promotes IgA production and has immunomodulatory effect.Hepatocyte growth factor(HGF)can not only promote gastrointestinal tract development as a nutritional factor, but also may work as an immune factor to enhance immunity.Neurotrophic factors promote early neurogenesis in the offspring of preeclampsia mothers.At the same time, the content of these growth factors in breast milk is related to the gestational age, region, diet and other factors.This article summarizes the research progress and clinical application value of these growth factors.

Objective:To analyze levels of carnitine and acylcarnitine in peripheral blood from septic infants and to investigate their changes and clinical values in sepsis in infants.Methods:This retrospective research involved 46 septic infants and 55 infants with noninfectious diseases who were hospitalized in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine.The clinical data were collected, the levels of carnitine and acylcarnitine in peripheral blood measured by tandem mass spectrometry were compared between the two groups, and the correlations of acylcarnitine levels with CRP and PCT were analyzed respectively.The septic infants were divided into two groups according to whether there were complications or not.The levels of free carnitine and acylcarnitine were compared between the two groups.Results:The levels of C6DC, C14: 1, C14OH and C16OH in peripheral blood were significantly higher in septic infants than those with noninfectious diseases( Z=-2.52、-2.05、-2.68、-2.82, all P<0.05). There is no significant difference in free carnitine level between two groups.These four acylcarnitine levels were positively correlated with PCT( r=0.44、0.44、0.40、0.49, all P<0.01). In septic group, the percent of infants with abnormal levels of C16OH was significantly higher in infants with complications than those without complications( χ2=4.51, P<0.05). Conclusion:The peripheral blood levels of several acylcarnitine elevate in septic infants, and have positive correlations with the strength of infection.Meanwhile, there is a higher proportion of having abnormal level of long chain acylcarnitine among infants with complications than those without complications.These results suggest that lipid metabolism has changed in septic infants and detecting acylcarnitine levels can be helpful in assessing the severity of sepsis.

Objective:To investigate the difference in the peri-coronary fat attenuation index (FAI) between using coronary calcium score (CCS) images and coronary CT angiography (CCTA) images, and to explore the feasibility and befitting threshold of FAI measured on CCS images.Methods:The clinical and imaging data of patients who underwent CCTA examination from August 2019 to August 2020 were retrospectively analyzed in the First Affiliated Hospital of Soochow University. According to the inclusion and exclusion criteria, there were 122 cases in non-calcified plaque group (144 coronary arteries) and 97 cases in none-plaque group (186 coronary arteries). The coronary arteries were delineated both on CCS and CCTA images with Perivascular Fat Analysis Tool; the regions of interest of peri-coronary adipose tissue were generated automatically after setting the threshold of fat tissue. Then the FAI value was calculated. The thresholds were set in four levels (-190--30, -185--25, -180--20 and -175--15 HU) for CCS images and one level (-190--30 HU) for CCTA images. The intra-class correlation coefficient (ICC) was used to evaluate the consistency of the measurements of FAI values on CCS and CCTA images between the two physicians. Paired t test was used to compare the differences of FAI values between CCS and CCTA images, and Pearson correlation coefficient was used to evaluate the correlation between CCS-FAI and CCTA-FAI. Results:(1) FAI values measured on CCS and CCTA images by 2 physicians showed good consistency; (2) At the threshold of -185--25 HU, there was no significant difference in FAI values between the CCS and CCTA images for non-calcified plaque group [(-84.15±5.99)HU vs. (-83.83±5.98)HU, t=0.79, P=0.429], as well as for the none-plaque group [(-83.41±5.75)HU vs.(-83.84±6.25)HU, t=-1.08, P=0.280]; (3) There were significant differences on FAI values between the CCS images and CCTA images at the threshold of -190--30、-180--20 and -175--15 HU (all P<0.05); (4) There were moderate correlations on FAI values between the CCS images and CCTA images under different thresholds both in non-calcified plaque group and none-plaque group. Conclusion:It is feasible to measure FAI on CCS images, and the befitting threshold is -185--25 HU.