Objective To investigate the predictive effect of serum CDH13 methylation for the progression after TURBT in the patients with non-muscle invasive bladder cancer.Methods Ninety-eight patients with non-muscle invasive bladder cancer treated by TURBT in this hospital from January 2010 to January 2012 were selected.The methylation specific PCR was used to detect the methylation status of serum CDH13.Then its correlation with the clinicopathological data as well as postoperative progression situation was analyzed.Results Serum CDH13 methylation was detected in 52 cases (53.1％),moreover serum CDH13 methylation was closely correlated with tumor size,grade and number (P＜0.05).During follow-up,20 cases (20.4％) appeared the tumor progression.The Kaplan-Meier analysis and log-rank test found that the patients with serum CDH13 methylation had shorter progression-free survival rate than the patients without serum CDH13 methylation,and the difference was statistically significant (P=0.007).The Cox regression analysis showed that serum CDH13 methylation was an independent risk factor for the progression after TURBT in non-muscle invasive bladder cancer.Conclusion Serum CDH13 methylation can serve as a predictive indicator of the progression after TURBT in non-muscle invasive bladder cancer.

The size of the non-sampling error is directly related to the accuracy and reliability of the sampling survey result. This paper studied the non-sampling errors generated during the sampling process of the China National Human Biomonitoring Program(CNBP), mainly including the sampling frame error, non-response error and measurement error. The program reduced the influence of the non-sampling error on the quality of the survey effectively by scientifically designing the sampling scheme and questionnaire, strengthening investigator trainings and standardizing the data review, which could be used to provide reference for the control of non-sampling errors in public health monitoring projects in China.

Objective To investigate the effects of flavone from Galium verum L (FGVL) on hydrogen peroxide induced oxidative injury in human umbilical vein endothelial cells (HUVEC),and explore related mechanisms.Methods HUVEC were divided into five groups:control group (1640 complete medium),injured group (HUVEC treated with 100 μmol/L hydrogen peroxide for 4 h),FGVL group (HUVEC treated with 12.5 mg/L FGVL (group F1),25.0 mg/L (group F2),50.0 mg/L (group F3) for 24 h before hydrogen peroxide).The nitric oxide content was measured by nitric acid reductase method.The 6-keto-Prostacyclin-F1α (6-keto-PGF1α),thromboxane B2 (TXB2),interleukin (IL)-6 and IL-22 were determined by ELISA.mRNA expression of phosphatidylinositol 3-kinase (PI3K),protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS) was detected by RT-PCR.Protein expression of p-Akt (ser473) and p-eNOS (ser1177) was determined by Western blot.Cell apoptosis was observed with fluorescence microscope after Hoechst33258 staining.Results (1) The contents of nitric oxide were significantly lower in the injured group than in the control group ((34.11 ± 1.78) μmol/L vs.(74.81 ± 2.93) μmol/L,P ＜ 0.05),which was significantly increased in group F2 ((41.86 ±2.32) μmol/L) and group F3 ((62.79 ± 1.16) μmol/L) compared with injured group (both P ＜ 0.05).(2)The secretion level of 6-keto-PGF1α was significantly lower in the injured group ((44.84 ± 3.87) ng/L) than in the control group ((82.38 ± 3.98) ng/L,P ＜ 0.05),which was significantly increased in group F1 ((52.76 ± 1.78) ng/L),FGVL 2 group which was(56.58 ± 1.44) ng/L and FGVL 3 group which was (67.78 ± 2.02) ng/L than that of injured group(all P ＜ 0.05).The secretion level of TXB2 was significantly higher in the injured group ((43.37±3.96) ng/L) than in the control group ((25.56 ± 1.75) ng/L,P ＜0.05),which was significantly reduced group F2 group ((32.41 ±1.68) ng/L) and group F3 ((28.23 ± 2.15) ng/L) than that of injured group(both P ＜ 0.05).(3) The contents of IL-6 and IL-22 were significantly higher in the injured group ((539.74 ± 11.63) ng/L) and ((23.70 ± 3.05) ng/L,respectively) than in the control group ((288.67 ± 19.52) ng/L) and ((23.70 ± 3.05) ng/L,respectively,both P ＜ 0.05).The contents of IL-6 were significantly lower in group F1,F2 and F3 compared to that of injured group(all P ＜ 0.05).The contents of IL-22 were significantly lower in group F2 and F3 than that of injured group(both P ＜ 0.05).(4) The relative levels of PI3K mRNA and eNOS mRNA in injured group (0.68 ± 0.09 and 0.22 ± 0.03,respectively) were significantly lower compared to control group(0.81 ±0.12 and 0.63 ±0.11,respectively,bothP＜0.05),PI3KmRNAin group F2 (0.76 ±0.03) and group F3 (PI3K mRNA 0.83 ± 0.06) as well as eNOS mRNA in group F1 (0.37 ± 0.08),F2 (0.53 ± 0.04) and F3 (0.56 ± 0.09) than those of injured group(all P ＜ 0.05).The mRNA expression of Akt was similar among groups (P ＞ 0.05).(5) The relative levels of p-Akt (ser473) and p-eNOS (ser1177) in injured group (0.48 ± 0.05 and 0.23 ± 0.03,respectively) were significantly lower compared to control group (0.71 ± 0.12 and 0.66 ± 0.05,respectively,both P ＜0.05),which was up-regulated in group F1,F2 and F3 groups compared to injured group(all P ＜ 0.05).(6) The cell apoptosis rate in injured groups was significantly higher compared to control group which ((63.67 ± 11.37)％ vs.(4.67 ± 1.15)％,P ＜0.05) which was significantly reduced in group F1((43.33 ±4.16)％),F2((18.33 ±4.93)％) and F3((15.67 ±2.08)％) compared to injured group (all P ＜ 0.05).Conclusion The FGVL can reduce hydrogen peroxide induced oxidative injury in HUVEC by increasing the level of nitric oxide through PI3K/Akt/eNOS pathway.

BACKGROUNDUp to now, locally advanced non-small cell lung cancer simutaneously involving carina, heart and great vessels is still regarded as contraindication for surgical treatment. However, the prognosis is very poor in these patients treated with chemotherapy and/or chemoradiotherapy. The aim of this study is to summarize the clinical experiences of carinoplasty combined with heart and great vessel plasty in the treatment of 84 patients with locally advanced non-small cell lung cancer involving carina, heart and great vessels or both in our hospital.

METHODSFrom March, 1988 to December, 2004, carinal resection and reconstruction combined with heart, great vessel plasty was performed in 84 patients with locally advanced non-small cell lung cancer involving carina, heart and great vessels simutaneously. The operative procedures in this series included as follows: (1) Right upper sleeve lobectomy combined with carinal resection and reconstruction, and right pulmonary artery sleeve angioplasty in 9 patients; (2) Right sleeve pneumonectomy combined with partial resection and reconstruction of left atrium, and superior vena cava resection and Gortex grafts in 3 cases; (3) Left upper sleeve lobectomy combined with carinoplasty, left pulmonary artery sleeve angioplasty and partial resection and reconstruction of left atrium in 3 cases; (4) Right upper sleeve lobectomy combined with carinoplasty, right pulmonary artery sleeve angioplasty and partial resection and reconstruction of left atrium in 10 cases; (5) Left upper sleeve lobectomy combined with carinoplasty and left pulmonary artery angioplasty in 9 cases; (6) Left upper sleeve lobectomy combined with carinoplasty, left pulmonary artery sleeve angioplasty and resection of the aorta arch sheath in 6 cases; (7) Right upper-middle sleeve lobectomy combined with carinoplasty and right pulmonary artery sleeve angioplasty in 3 cases; (8) Left upper sleeve lobectomy combined with carinoplasty, left pulmonary artery angioplasty, resection of the aorta arch sheath and partial resection and reconstruction of left artium in 8 cases; (9) Right upper sleeve lobectomy combined with carinoplasty, right pulmonary artery angioplasty and partial resection and reconstruction of left atrium in 4 cases; (10) Left sleeve pneumonectomy combined with partial resection and reconstruction of left atrium in 3 cases; (11) Right upper-middle sleeve lobectomy combined with carinoplasty, right pulmonary artery angioplasty and superior vena cava resection and reconstruction with Gortex grafts in 23 casese; (12) Right sleeve pneumonectomy combined with partial resection and reconstruction of left atrium in 1 case; (13) Right upper-middle sleeve lobectomy combined with carinoplasty, right pulmonary artery angioplasty and partial resection and reconstruction of left atrium in 1 case; (14) Right upper-middle sleeve lobectomy combined with carinoplasty, right pulmonary artery angioplasty and right inferior pulmonary vein sleeve resection and reconstruction in 1 case.

RESULTSThere were two operative death in this series. The operative mordality was 2.38%. A total of 32 patients had operative complications. The incidence of operative complications was 38.10%. The 1-, 3-, 5-and 10-year survival rate was 81.34%, 59.47%, 31.73% and 24.06% respectively.

CONCLUSIONS(1) It is feasible in technique that carinal resection and reconstruction combined with heart, great vessel plasty in the treatment of locally advanced non-small cell lung cancer involving carina, heart and great vessels simutaneously; (2) Multiple modality therapy based on carinal resection and reconstruction combined with heart and great vessel plasty can remarkably increase the survival rate, and improve the prognosis and quality of life in patients with locally advanced non-small cell lung cancer involving carina, heart and great vessels.

Objective:To investigate the association between oxygen saturation (SpO 2) and risk of 3-year all-cause mortality among Chinese older adults aged 65 or over. Methods:The participants were enrolled from Healthy Aging and Biomarkers Cohort Study in year of 2012 to 2014 in 9 longevity areas in China. In this prospective cohort study, 2 287 participants aged 65 or over were enrolled. Data on SpO 2 and body measurements were collected at baseline in 2012, and data on survival outcome and time of mortality were collected at the follow-up in 2014. Participants were divided into two groups according to whether SpO 2 was abnormal (SpO 2<94% was defined as abnormal). Results:The 2 287 participants were (86.5±12.2) years old, 1 006 were males (44.0%), and 315 (13.8%) were abnormal in SpO 2. During follow-up in 2014, 452 were died, 1 434 were survived, and 401 were lost to follow-up. The all-cause mortality rate was 19.8%, and the follow-up rate was 82.5%. The mortality rate of SpO 2 in normal group was 21.1%, and that of abnormal group was 41.6% ( P<0.001). After adjusting for confounding factors, compared to participants with normal SpO 2, participants with abnormal SpO 2 had increased risk of all-cause mortality with HR (95% CI) of 1.62 (1.31-2.02); HR (95 % CI) was 1.49 (0.98-2.26) for males and 1.71 (1.30-2.26) for females in abnormal SpO 2group, respectively; HR (95% CI) was 2.70 (0.98-7.44) for aged 65-79 years old, 1.22 (0.63-2.38) for aged 80-89 years old, and 1.72 (1.35-2.19) for aged over 90 years old in abnormal SpO 2 group, respectively. Conclusion:Abnormal SpO 2 was responsible for increased risk of 3-year all-cause mortality among Chinese elderly adults.

Objective:To investigate the association between oxygen saturation (SpO 2) and risk of 3-year all-cause mortality among Chinese older adults aged 65 or over. Methods:The participants were enrolled from Healthy Aging and Biomarkers Cohort Study in year of 2012 to 2014 in 9 longevity areas in China. In this prospective cohort study, 2 287 participants aged 65 or over were enrolled. Data on SpO 2 and body measurements were collected at baseline in 2012, and data on survival outcome and time of mortality were collected at the follow-up in 2014. Participants were divided into two groups according to whether SpO 2 was abnormal (SpO 2<94% was defined as abnormal). Results:The 2 287 participants were (86.5±12.2) years old, 1 006 were males (44.0%), and 315 (13.8%) were abnormal in SpO 2. During follow-up in 2014, 452 were died, 1 434 were survived, and 401 were lost to follow-up. The all-cause mortality rate was 19.8%, and the follow-up rate was 82.5%. The mortality rate of SpO 2 in normal group was 21.1%, and that of abnormal group was 41.6% ( P<0.001). After adjusting for confounding factors, compared to participants with normal SpO 2, participants with abnormal SpO 2 had increased risk of all-cause mortality with HR (95% CI) of 1.62 (1.31-2.02); HR (95 % CI) was 1.49 (0.98-2.26) for males and 1.71 (1.30-2.26) for females in abnormal SpO 2group, respectively; HR (95% CI) was 2.70 (0.98-7.44) for aged 65-79 years old, 1.22 (0.63-2.38) for aged 80-89 years old, and 1.72 (1.35-2.19) for aged over 90 years old in abnormal SpO 2 group, respectively. Conclusion:Abnormal SpO 2 was responsible for increased risk of 3-year all-cause mortality among Chinese elderly adults.

Objective: To understand the current status of BMI of the elderly and related factors in longevity areas in China, and provide scientific evidence for the control of BMI level in elderly population. Methods: Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. A total of 2 825 elderly in 8 longevity areas in China were surveyed and measured in 2017. The BMI levels of 2 217 elderly aged 65 years and older were calculated and in follow up. The ordered classification logistic regression model was used to analyze the influencd factors for the BMI in the elderly. Results: The BMI of the elderly in 8 longevity areas in China was (22.36±3.87) kg/m², and it was (22.76±3.58) kg/m² for males and (21.75±3.98) kg/m² for females. The BMI levels were normal in 1 165 elderly persons. The prevalence of underweight, overweight and obesity were 15.8%, 24.0% and 7.7%, respectively. Multivariate analysis showed that the main factors affecting the BMI of people under 100- years old were age (65-: OR=2.78, 95%CI: 1.87-4.15; 80-: OR=1.47, 95%CI: 1.00-2.17), smoking status (OR=0.46, 95%CI: 0.32-0.66), annual household income (<30 000 Yuan: OR=1.26, 95%CI: 1.07-1.47; 30 000-70 000 Yuan: OR=1.52, 95%CI: 1.12-1.86), and frequency of tea intake(OR=1.36, 95%CI: 1.01-1.71), while the factor in people aged ≥100 years was gender (OR=3.68, 95%CI: 1.32-10.36). Conclusions The prevalence of underweight, overweight and obesity were high in the elderly from longevity areas in China. It is necessary to pay attention to the trend of overweight and obesity due to smoking, higher annual household income and regular tea drinking in the elderly men.

Objective: To analyze influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China. Methods: We recruited 2 180 participants aged 65 years and older in 8 longevity areas from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey in 2017. Multivariate logistic regression analysis was performed to evaluate the relationships of socio-demographic characteristics, behavioral lifestyle, chronic disease prevalence, functional status, family and social support with depressive symptoms in the elderly. Results: The detection rate of depression symptoms was 15.0% in the elderly aged 65 years and older in 8 longevity areas of China, and the detection rate of depression symptoms was 11.5% in men and 18.5% in women. Multivariate logistic regression analysis results showed that the detection rate of depressive symptoms was lower in the elderly who had regular physical exercises (OR=0.44, 95%CI: 0.26-0.74), frequent fish intakes (OR=0.57, 95%CI: 0.39-0.83), recreational activities (OR=0.65, 95%CI: 0.44-0.96), social activities (OR=0.28, 95%CI: 0.11-0.73) and community services (OR=0.68, 95%CI: 0.50-0.93). The elderly who were lack of sleep (OR=2.04, 95%CI: 1.49-2.80), had visual impairment (OR=1.54, 95%CI: 1.08-2.18), had gastrointestinal ulcer (OR=2.97, 95%CI: 1.53-5.77), had arthritis (OR=2.63, 95%CI: 1.61-4.32), had higher family expenditure than income (OR=1.80, 95%CI: 1.17-2.78) and were in poor economic condition (OR=4.58, 95%CI: 2.48-8.47) had higher detection rate of depressive symptoms. Conclusion The status of doing physical exercise, fish intake in diet, social activity participation, sleep quality or vision, and the prevalence of gastrointestinal ulcers and arthritis were associated with the detection rate of depressive symptoms in the elderly.

Objective: To understand the relationship between visual impairment and risk of all-cause mortality in the elderly aged 65 years and older in 8 longevity areas in China. Methods: The data of the elderly aged 65 years and older in the project in 2012 were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, including physical measurement and survival status, and a follow-up for survival outcomes were conducted in 2014 and 2017 respectively. Cox proportional hazard regression model was used to analyze the influence of visual impairment on mortality. Gender and age specific analysis was conducted. Results: A total of 1 736 elderly adults were included. A total of 943 deaths occurred during the 5-year follow-up period with a 5-year mortality rate of 54.3%. The 5-year mortality rate was 76.7% in the group with visual impairment, and 47.6% in the group without visual impairment (P<0.001). After adjusting for demographic information, life style and some disease factors, the risk of 5-year mortality in the group with visual impairment group was 1.30 times higher than that in the group without visual impairment (HR=1.30, 95%CI: 1.09-1.55). In the females, the risk for mortality in the group with visual impairment was 1.48 times higher than that in the group without visual impairment (HR=1.48, 95%CI:1.20-1.84). However, vision status was not associated with the risk for mortality in males (HR=1.02, 95%CI: 0.72-1.43). The risk for mortality in the group with visual impairment was 1.39 times higher than that in the group without visual impairment in the elderly aged over 90 years (HR=1.39, 95%CI: 1.13-1.70). Vision status was not associated with mortality risk in the elderly aged 65-79 years and 80-89 years (HR=1.37, 95%CI: 0.61-3.07; HR=0.95, 95%CI: 0.61-1.48). Conclusion In the elderly people in China, visual impairment is a risk factor for mortality.

Objective: To investigate the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in the elderly aged 65 years and older in longevity areas in China. Methods: Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, 1 802 elderly adults were collected in the study during 2012-2017/2018. In this study, the elderly were classified into 4 groups, moderate-to-severe group [<45 ml·min^-1·(1.73 m²)^-1], mild-to-moderate group [45- ml·min^-1·(1.73 m²)^-1], mild group [60- ml·min^-1·(1.73 m²)^-1] and normal group [≥90 ml·min^-1·(1.73 m²)^-1] according to their eGFR levels. Results: After 6 years of follow-up, 852 participants died, with a mortality rate of 47.3%. Multivariate Cox regression analysis showed that the levels of eGFR were negatively correlated with all-cause mortality risk in the elderly (the HR of elderly was 0.993 and the 95%CI was 0.989-0.997 for every unit of eGFR increased, P=0.001), while compared with the group with normal eGFR, the HRs (95%CI) of the elderly in the moderate-to-severe group, mild-to-moderate group, and mild group were 1.690 (1.224-2.332, P=0.001), 1.312 (0.978-1.758, P=0.070), 1.349 (1.047-1.737, P=0.020) respectively [trend test P<0.001]. Conclusion The decrease in eGFR was associated with higher mortality risk among the elderly in longevity areas in China.