The prevalence of Alzheimer's disease(AD)increases along with the increase of human lifespan.AD has become one of the leading death causes.However,the exact etiology of AD remains unclear.More evidences have demonstrated that dietary factors play key roles in the pathogenesis of AD.Nutritional status evaluation and nutrition support are important in the early prevention and treatment of AD.

The risk factors for ischemic stroke in the very old (≥ 80 years) are not exactly the same as other populations (＜ 80 years). Compared to other age groups, the incidence of ischemic stroke in the very old female population is higher, and the traditional risk factors such as atrial fibrillation and hypertension are more common, whereas diabetes, hyperlipidemia, smoking and drinking are less common. It is uncertain that whether heart failure, ischemic heart disease and high creatinine level increase the risk of ischemic stroke. Overall, the effect of traditional risk factors on ischemic stroke in the very old remains to be further studied.

A total of 94 patients aged 80 years or over diagnosed as acute ischemic stroke based on their clinical features and CT or MRI and 64 elderly people without stroke as controls were enrolled in this study. They were admitted in Beijing Hospital from September 2003 to July 2008. Blood pressure measurement, electrocardiogram (ECG) and color doppler ultrasonography in carotid arteries were performed for all of them, as well as blood glucose, lipid and fibrinogen were measured and history of hypertension,diabetes, coronary heart disease, hyperlipidemia, smoking and alcohol drinking were recorded. Univariate analysis showed that more hypertension, hyperfibrinogenemia, atrial fibrillation and carotid atherosclerosis were found in the elderly patients with ischemic stroke than in those without it ( P ＜ 0. 05 ). And, multivariate logistic regression analysis showed that hyperfibrinogenemia ( OR = 16. 23, P = 0. 009 ), atrial fibrillation ( OR = 3.47, P = 0. 080) and isolated systolic hypertension ( OR = 1.05, P ＜ 0. 01 ) all were independent risk factors for ischemic stroke in the elderly.

Objective To investigate the effect of alendronate combined with calcitriol on bone metabolism in the treatment of postmenopausal osteoporosis patients.Methods66 postmenopausal osteoporosis patients from Cancer Hospital of Hangzhou were selected and randomly divided into the control group and the study group.33 cases in the control group were treated by compound calcium amino acid chelate.33 cases in the study group were treated by compound calcium amino acid chelate, alendronate and alfacalcidol.All patients were taking the drug for 48 weeks.The bone mineral density (BMD) of lumbar vertebrae between 4 and 1, Bone alkaline phosphatase (BALP) and bone metabolism index of left femur (BMD) Type I collagen C end peptide (CTX), acid phosphatase (TRAP), parathyroid hormone (PTH) and clinical curative effect were compared.ResultsAfter treatment, the clinical effective rate of the study group (93.94%) was higher than that of the control group (72.73%), the difference was statistically significant (P<0.05).Compared with the control group,the level of bone mineral density of lumbar spine was increased from 1 to 4, and the level of TRAP, CTX, PTH and BALP were increased,the difference was statistically significant (P<0.05).There was no difference in adverse effects between the two groups.ConclusionThe combination of the application of sodium hyaluronate and the combination of the method can effectively improve the bone mineral density and bone metabolism in postmenopausal women with osteoporosis, and improve the clinical efficacy.

Objective To investigate,the significance of serum high-sensitivity C-reactive protein (hs-CRP) concentration in subjects with various glucose tolerance and study the role of hs-CRP in patients of impaired glucose tolerance (IGT) and diabetes mellitus.Method All subjects in the study underwent oral glucose tolerance test (OGTT).Determination of serum hs-CRP levels in normal glucose tolerance(NGT),IGT and type 2 diabetes mellitus (T2DM) patients were made by immunologic projective turbidimetry method.Results The levels of serum hs-CRP were (1.57 + 0.46) mg/L in NGT patients,(2.84 ±0.48) mg/L in IGT patients,and(4.18± 0.76) mg/L in T2DM patients.The levels of serum hs-CRP were positively correlated with body mass index,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,OGTr 2 hPG,triglyceride,and total cholesterol.ConclusionsInflammation has already existed not only in T2DM patients but also in subjects with IGT.Inflammation might participate in the oeeurrance and development of T2DM.hs-CRP as an inflammator factor can be used to predict and monitor T2DM.

Objective To explore the value of serum 1,5-AG in the diagnosis of diabetes mellitus by applying the method of pyranose oxidase (PROD). Methods 1,5-AG,FPG、2hPG and HbA_1c were determined in 50 case of DM,100 case of IGT and 30 control subject. ROC curve was applied to evaluate the diagnostic efficiency of 1,5-AG,FPG and HbA_1c for DM. Results Serum 1,5-AG was obviously lower in the diabetes than in IGT and controls(P＜0.01). Compared with controls, IGT patients had lower serum 1,5-AG(P＜0.05).1,5-AG level had significantly negative correlation with FPG,2hPG and HbA_1c respectively. The area under the ROC curve of 1,5-AG,FPG and HbA_1c are 0.948、0.921、0.817,respectively. Conclusions 1,5-AG level shows significantly correlation with glucose tolerance. Serum 1,5-AG measurement could be used as useful indicator in the screening of diabetes mellitus as well as in the monitoring of glycemic control.

Objective To investigate the risk factors that worsened the pathologic course of acute ischemic stroke .Methods The clinical data of 264 patients with acute ischemic stroke treated in Shijitan hospital were analyzed retrospectively .According to the outcome ,the patients were divided into deterioration group (70 cases) and improved group(194 cases) .The clinical data ,labora-tory examination results of the patients were collected through self-made survey and compared between the two groups .The risk factors that worsened the pathologic course of acute ischemic stroke were analyzed by multiple linear regression .Results There were 42 .86% patients with hyperlipidemia history and 70 .00% with diabetes history in the deterioration group ,which were signifi-cantly higher than the improved group(P<0 .05) .The levels of glucose ,glycosylated hemoglobin ,fibrinogen ,serum ferritin ,C reac-tive protein ,low density lipoprotein cholesterol in the deterioration group were significantly higher than those in the improved group (P<0 .05) .Multiple linear regression analysis showed that hyperlipidemia history ,high level of C reactive protein ,and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke . Conclusion Hyperlipidemia history ,high level of C reactive protein ,and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke .According to these factors ,patients were e-valuated and targeted measures were made to improve the prognosis of the patients .

Abstract: Objective To analyze the changes in the pathogen spectrum of severe lower respiratory tract viral infections in children before and during the outbreak of the COVID-19 pandemic, and to explore the epidemiological characteristics to provide a basis for preventing respiratory viral infections. Methods We conducted a retrospective analysis of clinical data from patients with severe viral pneumonia admitted to the pediatric intensive care unit (PICU) of Shenzhen Children's Hospital from January 2017 to December 2021. Taking the outbreak of the COVID-19 pandemic as the cut-off point, it is separated into the period before the outbreak of the COVID-19 pandemic and the period during the pandemic. Virus spectrum and clinical data between the two groups were analyzed using the chi-square test or Fisher's exact probability method. Results A total of 712 cases of severe viral pneumonia were reported, including 469 males and 243 females, with a median age of 1.25 (0.50, 3.83) years. Among them, 495 cases were under 3 years old, and 626 cases were under 6 years old. The median duration of illness before admission to the PICU was 3.00 (2.00, 5.00) days. Hospital-acquired infections were seen in 6.88% of the children. Firty-four children had been hospitalized ≥2 times due to repeated infections. The detected viruses were influenza viruses (IVA and IVB) in 223 cases (160 IVA and 70 IVB), respiratory syncytial virus (RSV) in 215 cases, human rhinovirus (HRV) in 125 cases, adenovirus (ADV) in 91 cases, human parainfluenza viruses (HPIV) in 53 cases, human bocavirus (HBoV) in 34 cases, cytomegalovirus (CMV) in 26 cases, human metapneumovirus (HMPV) in 17 cases, and human coronavirus (HCoV) in 7 cases. A total of 634 cases were infected with a single virus, while 78 cases were infected with multiple viruses. The top three viruses, sorted by age, were as follows: <1 year: RSV, IVA/B, and HRV; 1-<3 years: IVA/B, RSV, and ADV; 3-<6 years and 6-<10 years: IVA/B, HRV, and ADV; 10-<14 years: HRV, IVA/B, and CMV; sorted by time distribution: March-May and June-August: RSV, IVA/B, and ADV; September-November: RSV, HRV, and IVA/B; December-February: IVA/B, RSV, and HRV. Before the COVID-19 epidemic, the top three viruses were IVA/B, RSV, and ADV, while during the COVID-19 epidemic were HRV, RSV, and HPIV. Conclusions During the COVID-19 pandemic, the viral spectrum of severe lower respiratory tract viral infections in the PICU changed. Before the pandemic, IVA/B, RSV, and ADV were prevalent, while during the pandemic, HRV, RSV, and HPIV were more prevalent. The viral spectrum varies among children of different age groups and in different months.

AIM　To explore the effect of berberine in inhibition of proliferation and induction of apoptosis of gastric cancer cell MGC-803.METHODS　The MGC-803 cell morphology and cell counting were studied by Trypan blue, MTT, Methyl green pyronin stain assay, the MGC-803 cell DNA changes were investigated by flow cytometry and agarose gel electrophoresis.RESULTS　Berberine could significantly inhibit the growth of MGC-803. After 48 hours of treatment with different concentration berberine (8, 4, 2, 1 mg*L-1), the inhibitive rate of MGC-803 were 86.7%, 65.9%, 20.0%, 0%, respectively. Meanwhile, MGC-803 showed typical apoptosis features: cell shrinkage, nuclear condensation, DNA fragmentation and formation of apoptotic bodies. A typical subdiploid peak before G0/G1 phase was observed by flow cytometry. The Trypan blue stain achromatophilia rates of death cells, which with well membranes, were between 60%～82%. Agarose gel electrophoresis analysis, which showed that the chromosomes of MGC-803 were broken by berberine before the structures of membrane were damaged, while DNA broke into long fragments rather than small fragments, supported that the activation effect of berberine on nuclease was mild.CONCLUSION　Berberine could significantly inhibit proliferation of gastric cancer cell MGC-803 and induced apoptosis, and the cytotoxicity of berberine on MGC-803 was weak.

Objective To explore the diagnostic value of GRE T2 ? WI sequences in low field strength MR with oblique coronal plane in patients with acute anterior cruciate ligament (ACL)injury.Methods 68 cases of acute traumatic hemarthrosis of the knee joint proved surgically were reviewed.The cases were divided into two groups:conventional MR group (axial image,standard coro-nal image and sagittal oblique image),and conventional with oblique coronal MR group.The diagnostic results with surgical and path-ological results were compared.The diagnostic accuracy of two images were evaluated respectively.Results For conventional MR group and conventional with oblique coronal MR group,the sensitivities in diagnosing ACL were 72.9% and 97.9%,the specificities were 80% and 85%,the positive predictive values were 89.7% and 94%,the negative predictive values were 55.2% and 85%,the accuracies were 52.9% and 82.9%,the misdiagnosis rates were 20% and 1 5%,the missed diagnosis rates were 27.1% and 2.1%, and the coincidence rates was 75% and 94.1%,respectively.The difference in diagnosis rates between two groups were statistically significant(P <0.05).Conclusion GRE T2 ? WI sequences with oblique coronal plane can significantly improve the diagnostic rate of anterior cruciate ligament injury.