Objective　To evaluate the safety and efficiency of percutaneous coronary interventions(PCI) in octogenarian Chinese with coronary artery disease.　Methods　A total of 43 patients aged over 80 years old underwent 45 such procedures at Queen Mary Hospital from October 1994 to May 1998. There were 27 male and 16 female 〔 mean age (82.3±2.5), range (80-89)〕. 55.8% of these patients had multi-vessel lesions. A total of 48 lesions in 43 patients was treated 〔25 LAD(52.1%), 11 LCX(22.9%) , 11 RCA(22.9%), 1 LM (2.1%)〕. 　Results　Thirty-seven (86.1%) patients were successfully performed PCI. Sixteen of them deployed stenting. Among the 6 lesions which failed to cross, 5 of lesions were LAD, 3 of them were total occlusion. The success rate and complication during the procedure were not significant difference compared with the control in 237 patients ＜80 years of age. At 18 months follow up, 78.5% of these patients was free or much improved of chest pain. The restenosis rate was 36.0% confirmed by coronary angiogram performed in 25 patients. 　Conclusions　In octogenarians with coronary artery disease PCI was a safe and effective procedure with a high successful rate, low acceptable complication rate and a favorable immediate and long term outcomes.

Objective To determine an early and noninvasive predictor of chronic kidney diseaase(CKD),by detecting the correlation between the urinary Col-Ⅳ concentration,the renal tissue and renal lesions in patients with CKD Col-Ⅳ expression.Methods 98 CKD patients proved by renal biopsy were selected and 76 healthy people were enrolled as control.Urinary and serum Col-Ⅳ concentration were examined by enzyme-linked immunosorbent assay(ELISA).Renal Col-Ⅳ expression was detected by immunohistochemistry.Renal injury grade was semiquantitative by CMIAS image analysis system.The association between urinary Col-Ⅳ level and renal Col-Ⅳexpression,as well as renal lesion was analyzed,meanwhile the proteinuria and glomerular filtration rate(GFR)were analysed simultaneously.Results Urinary Col-Ⅳ level in patients with CKD was significantly higher than that in control,however,there was no difference in blood Col-Ⅳ level.Expression of Col-Ⅳ could be found in the sclerosing glomeruli and tubulointerstitial tissue,and Col-Ⅳ expression degree was consistent with lesion degree.Urinary Col-Ⅳ level was correlated positively with renal Col-Ⅳ expression,as well as with density of glomerular basement membrane and interstitial damage.Elevated urinary Col-Ⅳ concentration was observed in patients with mild renal sclerosis prior to the change of GFR.No correlation between urinary Col-Ⅳ concentration and proteinuria was observed.Conclusions These results suggested urinary Col-Ⅳ concentration reflected renal Col-Ⅳ expression and renal sclerosis,and could predict the progression of CKD.

Objective To evaluate the effect of PTCA in patients younger than 40 years of age. Methods Patients aged 40 years or less who underwent PTCA were recruited. Clinical and angiographic data were reviewed. Results A total of 82 patients underwent such procedures. Successful PTCA were performed in 80 patients (97.56%), 93 lesions were treated (97.89%), resulting in an improvement in diameter stenosis from 84.5%?11.8% to 4.1%?1.2%. One patient (1.22%) required bypass surgery without death and Q-wave myocardial infarction. During 42.1?6.8 months′ follow-up, 3 patients died (non-cardial cause in two cases), 3 sustained a myocardial infaraction, and 1 required bypass surgery. 87.8% of patients were free of angina. The target vessel revascularisation rate (TVR) was 12.19%. Angiographic follow up were performed in 70 patients (8.4?5.2 months). The total restenosis rate was 31.43%, 13.16% in stent group. Conclusion Coronary angioplasty has a high immediate success rate and good long-term result when performed in young patients who can be treated safely and effectively with coronary interventions.

Objective To analyze the results of assessment and authentication of malaria elimination of 7 county?level cities and districts in Changzhou City,Jiangsu Province,and explore the suitable monitoring methods for malaria after the elimination in this region,so as to provide the evidence for formulating and adjusting the malaria elimination strategies and measures. Meth?ods The data from the network reports of malaria epidemic situation,blood examinations of febrile patients,epidemiological questionnaires of malaria cases,investigation of epidemic focuses and disposal tables were collected and analyzed in Changzhou City from 2009 to 2014. The clinicians were assessed with the closed?book written examinations for their ability of the diagnosis and treatment of malaria. The inspection personnel were assessed by the microscopical examinations of Plasmodium. Totally 30 negative blood slides were reviewed. In the natural village where the last local case of malaria was located ,200 blood filter pa?pers were collected for gene detection of Plasmodium. Results From 2009 to 2014,145 malaria cases were reported in Chang?zhou City. Totally 170 638 febrile patients received blood detections for malaria,of which 137 cases were positive and the posi?tive rate was 0.08%. The majority of malaria cases were imported except 8 local malaria infection cases in 2009 and 2 local ma?laria infection cases in 2010. Four of seven county?level cities(districts)gained an average score of 20 points on the microscopi?cal examinations of Plasmodium. Liyang City got a minimum average score of 18.8 points. In capacity assessment of malaria diag?nosis and treatment,Liyang City gained the highest average score of 19.8 points,and Qishuyan District got the lowest average score of 18.0 points. The malaria elimination assessment scores of the 7 county?level cities(districts)were all above 93 points. Four county?level cities(districts)(Xinbei District,Wujin District,Liyang City,and Jintan City)carried out the active case detections. A total of 731 cases were detected and the results were all negative. Liyang City in 2012,Zhonglou District and Jin?tan City in 2013,Tianning District,Qishuyan District,Xinbei District and Wujin District in 2014,passed the malaria elimina?tion assessment at county(district)level,respectively. Conclusions All the 7 county?level cities(districts)of Changzhou City have passed the malaria elimination assessment at a high score. After the malaria elimination ,the monitoring should contin?ue to consolidate the achievements.

Objective To evaluate the effect of comprehensive schistosomiasis control in Changzhou City in recent 10 years, so as to provide the evidences for formulating the future prevention and control strategy. Methods The work reports and the da?ta of the schistosomiasis comprehensive control projects in Changzhou City from 2004 to 2014 were collected,the infection sta?tus of residents and livestock as well the Oncomelania hupensis snail situation were analyzed,and the implementation effect of the comprehensive control projects was evaluated. Results From 2004 to 2014,totally 215 368 person?times were examined, and the positive rate of the blood examinations of the population was 0.24%(478/198 356),and there were no positive cases de?tected out by using the miracidium hatching method. Totally 11 935 domestic animals were detected and no positives were found. From 2004 to 2014,the total area with snails was 92.27 hm2,and marshland,inland and mountain environments accounted for 34.75%,34.82%and 30.43%,respectively. The newly discovered area with snails was 34.40 hm2,and marshland,inland and mountain environments accounted for 2.62%,71.22% and 26.16%,respectively. Totally 8 511 snails were dissected and no schistosome infected snails were found. From 2004 to 2014,a total of 242 600 harmless toilets were built,2 704 700 domestic animals were reared in pens,5.82 km?long rivers were dredged,2 250.11 hm2 of protective forests were constructed,a total area of 625.79 hm2 were controlled with molluscicides,and an area of 149.58 hm2 were environmentally transformed. Totally 5.4 mil?lion people received health education. The awareness rate of knowledge on schistosomiasis control of residents was 96.00% in 2014. Conclusions There exists the risks of snails import and diffusion and schistosomiasis resurrection in Changzhou City, but under the condition of continuous implementation of comprehensive control measures,the endemic situation of schistosomia?sis is stable and the control achievement is consolidated in this city.

Objective To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action,so as to provide the evidence for achieving the target of malaria elimination. Methods The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at differ-ent levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. Results Totally 95 people were investigated,and among them,40.0%had college degree and 45.3%were university educated. There were 18.9%of them working on Plasmodium microscopy examinations for less than 1 year,40.0%for 2-5 years,18.9%for 6-10 years and 22.1%for more than 10 years. The numbers of person-time of provincial and municipal level training,district-level training,and unit-level training in the last year were 0.57,0.59,and 0.14,respectively. Totally 18.9%of them had the experience of finding Plasmodium at work,and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examina-tions. However,57.9%and 8.4%of them considered Plasmodium microscopy examinations increased their work load and work dif-ficulty,respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5%and 91.6%re-spectively(P<0.05). The average mark of Plasmodium microscopic tests was 25.3 points(full mark being 50 points),and the passing rate(≥30 points)was 58.9%. Conclusion The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor,and the related training should be enhanced.

Objective To understand the quality of blood smears for Plasmodium detection in Changzhou City,so as to pro?vide the technical support for malaria surveillance in the post?elimination period. Methods The blood smears of fever patients from each cities(districts)in Changzhou City in 2014,including more than 3%of the negatives and all the positives,were se?lected. The quality of the blood smear making,dyeing,cleanliness and results were reviewed by the experts from the municipal malaria microscopy station,and the data were analyzed statistically. Results Totally 996 negative blood smears were reviewed in 2014,with a review rate of 4.52%. The qualified rates of blood smear making,dyeing and cleanliness were 92.87%,93.27%and 94.48%,respectively. A total of 34 positive blood smears were reviewed,and there were no false detections and leak detec?tions. The qualified rates of blood smear making and dyeing were more than 90%in all the seven cities(districts). As for quali?fied rate of cleanliness,except the rate in Qishuyan District(81.36%),those in the other six cities(districts)were all above 90%. The qualified rates of blood smear making,dyeing and cleanliness were all more than 90%in first?class,second?class and third?class hospitals. The major quality defects of the blood smears were sediment,abnormal making and thick membrane shed?ding,and the proportions were 25.91%,21.76%and 19.17%,respectively. Conclusions The quality of blood smears for Plas?modium detection in Changzhou City is satisfying. In the future,the training and supervision still should be strengthened to guar?antee the capacity of microscopic examinations for Plasmodium detection in the surveillance of post?elimination period.

Objective To grasp the malaria epidemic situation in Changzhou City from 2010 to 2014,so as to provide the ev?idence for formulating and adjusting malaria control strategies and measures. Methods The epidemiological data of malaria cas?es in the special report system from 2010 to 2014 were collected,and the malaria epidemic situation and the diagnosis and treat?ment of malaria patients were analyzed. Results There were 132 malaria cases reported in Changzhou City from 2010 to 2014, with a decrease of 27.47%compared to 182 cases from 2005 to 2009. Among the 132 cases,2 cases were local infected cases and the remaining 130 cases were imported cases. Four cases were clinically diagnosed and 128 cases were laboratory con?firmed,with 97 cases of malignant malaria,14 cases of vivax malaria,13 cases of ovale malaria,and 4 cases of quartan malar?ia. The 132 cases were distributed in five districts:56 cases in Jintan City,51 cases in Liyang City,19 cases in Tianning Dis?trict,3 cases in Wujin District,and 3 cases in Xinbei District. The median duration between the onset and treatment of the dis?ease was 2 days,and the median duration between the diagnosis and treatment was 1 day. The diagnosing units were concentrat?ed on the county?level disease control agencies,and medical institutions at county and municipal levels,accounting for 92.42%(122/132). From 2011 to 2014,there were no local malaria cases. Conclusions From 2012 to 2014,there have been no local malaria cases in Changzhou City,and the goal of eliminating malaria has been achieved basically. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,imported malaria is still the key of malaria prevention and control.

Objective To analyze the epidemic characteristics of imported malaria in Liyang City,so as to provide the evi?dence for formulating appropriate control strategies and measures. Methods The malaria epidemic situation reports,case epi?demiological investigations and the follow?up materials of counterparts returned together with the cases were collected and ana?lyzed in Liyang City from 2007 to 2014. Results Totally 53 imported malaria cases were reported and they were all laboratory confirmed in Liyang City from 2007 to 2014. Forty ? nine cases(92.5%)were imported from African countries,37 cases (69.8%)were Plasmodium falciparum infection,and 37 cases(69.8%)had overseas incidence history. Forty cases(75.5%) were aged between 30 and 49 years,and 52 cases(98.1%)were male,42 cases(79.2%)were farmers. These cases were dis?tributed in all the 10 towns and there were no obvious seasonal variation for onset time. The median time from onset to seeing a doctor was 3 d,and the median time from seeing a doctor to being diagnosed was 0 d. The first visit health facilities by the pa?tients were various,and the diagnostic health facilities were all the medical institutions at the county level or above,and the standardized treatment rate was 100%. Conclusion During the last 5 consecutive years,there have been no local infected ma?laria cases in Liyang City,and the remarkable results have been achieved in malaria elimination. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,the imported malaria is still the key of malaria preven?tion and control.

Objective To investigate the current situation of iodine deficiency disorders and the effect of control measures in Changzhou City, Jiangsu Province, and to provide a basis for making up targeted control measures for iodine deficiency disorders. Methods In 2012, proportional probability sampling method(PPS) was used to select 30 primary schools in seven counties of Changzhou City;50 students aged 8-10 in each school were randomly selected to examine thyroid, and their urine and household salt samples were collected to detect iodine. Thirty pregnant and 15 lactation women were selected to detect their urine iodine in the town where the school was located in. Two drinking water samples were collected to detect iodine in the village where the school was located in. The questionnaire survey of health education was carried out among the children and the housewives. Results A total of 1 500 children were surveyed, and the rate of goiter was 0.07%(1/1 500); the median of urinary iodine was 224.81 μg/L. Five hundred and seventy-two pregnant women and 328 lactation women were surveyed, and the median of urinary iodine was 148.93 μg/L and 147.48 μg/L, respectively. Fifteen hundred salt samples were detected, and the coverage rate of iodized salt was 99.47%(1 492/1 500); the edible rate of qualified iodized salt was 97.67%(1 465/1 500); and the median of salt iodine was 25.46 mg/kg. Sixty water samples were collected, and the median of water iodine was 3.63 μg/L. The health education awareness rates were 77.8%(2 100/2 700) and 88.0%(396/450) of students and housewives, respectively. Conclusion The control effect of iodine deficiency disorders is significant in Changzhou City, and monitoring of iodine nutrition level of special populations should be strengthened.