Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Objective To observe the expression level and diagnosis performance of serum exosomal miR-21 in lung cancer. Method Sera of 94 lung cancer patients,29 pulmonary tuberculosis patients,and 26 healthy controls from Nan Fang Hospital were collected. Exosomes in serum were purified and characterized ,and miRNA was abstracted from exosomes. Levels of exosomal miR-21 in three groups were compared with relative quantitative RT-PCR. Diagnosis performance of exosomal miR-21 was evaluated by ROC curve. Results Purified serum exosome sample possesses typical exosome features. There were significant difference among exosomal miR-21 levels from lung cancer ,tuberculosis ,and health control group. Exosomal miR-21 obviously increased in lung cancer patients,and decreased in tuberculosis patients. Exosomal miR-21 were increased in early and late stage lung cancer patients. The diagnostic performance of exosomal miR-21 was evaluated by ROC curve. Its area under the curve was 0.702 and specificity was 0.923. Conclusions Serum exosomal miR-21 was increased in many kinds of lung can-cer patients. It possesses excellent diagnosis performance ,which may be developed as new biomarkers to assist lung diagnosis.

Purpose To investigate the relevance between the expression of miR-339-5p and the clinicopathological characteristics in diffuse large B-cell lymphoma (DLBCL). Methods The level of miR-339-5p expression was detected in 123 cases of diffuse large B-cell lymphoma tissues and 20 cases of reactive lymphoid hyperplasia tissues by chromogenic in situ hybridization ( CISH) technique. The expression of Ki-67 and BCL-6 protein was examined in diffuse large B-cell lymphoma tissues by immunohistochemical technique (IHC) (EnVision two-steps), and the correlation between the expression of miR-339-5p and BCL-6 and the clinicopathological param-eters was also analyzed. Results The positive rates of miR-339-5p were 39. 8% (49/123) in DLBCL tissues, which was significantly lower than that in RH tissues (90%, 18/20). The positive rates of miR-339-5p were 31. 0% (22/71) for germinal center B-cell-like (ABC type) DLBCL, which was significantly lower than that in activated B-cell-like (GCB type) DLBCL (27/52, 51. 9%). The low-er expression of miR-339-5p in DLBCL was correlated with late Ann Arbor staging and high-risk group of international prognostic index (P<0. 05). The survival rates of miR-339-5p negative patients of ABC type and GCB type of DLBCL were significantly lower than that of the positive patients (P<0. 01). The levels of miR-339-5p expression in DLBCL were negatively correlated with the levels of BCL-6 expression in DLBCL (P<0. 01). Conclusion The low expression of miR-339-5p might be relatived with the progression and poor prognosis of DLBCL.

Objective: To quantitatively compare five occupational health risk assessment models in assessing silica dust hazard risk in small open pits, so as to provide the reference for the research of occupational health risk assessment methodology Methods : Seven small open pits were selected as the evaluation sites. The models from Singapore, the United Kingdom's Control of Substances Hazardous to Health Essentials ( COSHH Essentials ), Australia, Romania, and the International Council on Mining and Metals ( ICMM ) were applied to assessing the occupational health risk of the workers exposed to silica dust. The risk ratios ( RRs ) were calculated, and the parallelism, accuracy and correlation of the evaluation results of the five models were compared. Results : The RRs of the Singaporean model, COSHH model, Romanian model, Australian model and ICMM model were 0.8, 1.0, 0.4, 0.6 and 0.8, respectively. The Singaporean model and the Australian model were able to distinguish transport drivers from sprinkler drivers in the health risk exposed to silica dust, which was consistent with the actual risk of the two posts. Except for COSHH model, the RRs of the other four models were positively correlated ( P<0.05 ); the RRs were all positively correlated with concentration ratios ( CRs ) ( P<0.05 ), and the correlation coefficient between RRs and CRs of the Singaporean model was the largest (0.801). Conclusion Among the five models, the Singaporean model can more accurately evaluate the hazard risk of silica dust in posts of open pits, and has a good correlation with the other models.

Objective:To explore the current dilemmas in the survival and development of elderly-friendly medical institutions from the dual perspectives of medical staff and elderly patients,to optimize the construction of elderly-friendly medical institutions,to create a friendly,safe,and comfortable medical environment,provide comprehensive,continuous,and caring medical services for the elderly.Methods:Based on the questionnaire survey method,the existing dilemmas and development paths of elderly-friendly medical institutions from multiple dimensions were explored,including culture,management,service,and environment.Results:Quantitative research showed that elderly patients satisfaction with the friendly culture of the medical,but 28(21.1%)still thought that the medical staff did not communicate with them adequately,and 73(54.9%)thought that the institutions lacked health education and guidance for them.In the evaluation of the medical environment,the dissatisfaction of elderly patients was manifested as inadequate transportation facilities(33 visits),lack of barrier-free facilities(29 visits),and unclear medical guidance(25 visits).The results of the chi-square test showed that there was a statistically significant difference in waiting time for medical services among elderly patients based on gender(P<0.05),and women were more patient.There were statistically significant differences in the level of service convenience and satisfaction with geriatric syndrome assessment among elderly patients of different age groups(P<0.05).Qualitative research found that there were problems in the management of elderly-friendly medical institutions,such as cumbersome referral processes,low enthusiasm of medical staff,insufficient elderly professionals,and a lack of performance evaluation and training systems.Conclusion:To solve the existing difficulties of elderly-friendly medical institutions,it should start with paths of strengthening the training of medical staff,improving the hospital management system,upgrading the level of service specialization,and improving the aging-appropriate environment,to enhance the sense of accessibility of medical care for elderly patients and improve their quality of life.

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a serious global health threat.This raises an urgent need for the devel-opment of effective drugs against the deadly disease.SARS-CoV-2 non-structural protein 14 (NSP14)carrying RNA cap guanine N7-methyltransferase and 3'-5'exoribonuclease activities could be a potential drug target for intervention.NSP14 of SARS-CoV-2 shares 98.7％ of similarity with the one (PDB 5NFY) of acute respiratory syndrome (SARS) by ClustalW.Then,the SARS-CoV-2 NSP14 structures were modelled by Modeller 9.18 using SARS NSP14 (PDB 5NFY) as template for virtual screening.Based on the docking score from AutoDock Vina1.1.2,18 small molecule drugs were selected for further evaluation.Based on the 5 ns MD simulation trajectory,binding free energy (AG) was calculated by MM/GBSA method.The calculated binding free energies of Saquinavir,Hypericin,Baicalein and Bromocriptine for the N-terminus of the homology model were-37.2711 ± 3.2160,-30.1746 ± 3.1914,-23.8953 ± 4.4800,and-34.1350 ± 4.3683 kcal/mol,respectively,while the calculated binding free energies were-60.2757 ± 4.7708,-30.9955 ± 2.9975,-46.3099 ± 3.5689,and-59.8104 ± 3.5389 kcal/mol,respectively,when binding to the C-terminus.Thus,the compounds including Saquinavir,Hypericin,Baicalein and Bromocriptine could bind to the N-terminus and C-terminus of the homology model of the SARS-CoV-2 NSP14,providing a candidate drug against SARS-CoV-2 for further study.

Objective: To detect the changes of systolic function of left ventricle in patients with lymphoma receiving anthracycline by three dimensional speckle tracking imaging(3D-STI). Methods: Thirty patients with newly diagnosed diffused large B-cell lymphoma who had received R-CHOP chemotherapy were enrolled. Left ventricular global longitudinal strain (GLS), global circumferential strain(GCS) and longitudinal strain(LS) on different left ventricular segments were measured by 3D-STI at baseline, after the completion of 2 cycles and 4 cycles of the regimen respectively. Results: Compared with baseline, GLS reduced significantly after four cycles of anthracycline chemotherapy(P=0.002). Analysis of LS on different segments of the left ventricle shows: after 2 cycles of anthracycline chemotherapy, LS only on apical septum was significantly decreased(P=0.019). After 4 cycles of treatment, LS on mid anterior, mid anteroseptal, mid inferoseptal, mid anterolateral, apical anterior, apical septal walls and apex worsened (t=3.321, P=0.002; t=2.497, P=0.018; t=2.387, P=0.024; t=2.096, P=0.045; t=4.015, P=0.000; t=4.064, P=0.000; t=3.370, P=0.002, respectively). Conclusions LS deterioration emerges on some left ventricular walls in patients with lymphma underwent chemotheapy based on anthracycline in early stage of the remedy, especially on apex and mid segments. LS on apical septum manifests firstly. The segmental LS index maybe expected to be valuable for monitoring of early cardiotoxicity of antharcycline.

Objective To summarize the clinical feature,gene mutations,diagnosis,treatment,and follow-up data of protein-sensitive hypoglycemia,so as to improve the clinical understanding of the disease.Methods Five patients were diagnosed with protein-sensitive hypoglycemia during June in 2015 and December in 2017 from the Department of Pediatric Endocrinology and Inherited Metabolic Diseases,Children's Hospital of Fudan University.Clinical data of 5 cases were summarized,including clinical manifestations,findings of protein sensitivity test,therapy effect and prognosis.The endocrine and metabolic panel was used to investigate the genetic cause of four patients.Related literatures of protein-sensitive hypoglycemia were reviewed,and the phenotypes,genotypes,and therapy effects were summarized.Results Among the 5 patients diagnosed with positive results of protein-sensitive hypoglycemia,three were found to harbor glutamate dehydrogenase 1 (GLUD 1) mutations (c.965G ＞ A,p.R322H:2 cases;c.943C ＞T,p.H315Y:1 case),and another one had complex heterozygous mutations in L-3-hydroxyacyl-CoA dehydrogenase (HADH,c.29G ＞ C,p.R10P;c.89T＞ A,p.V30E).5 patients were euglycemia without any medical support after low protein diet.In 18 literatures retrieved and this study,there were totally 161 cases of protein-sensitive hypoglycemia (149 cases with GLUD1 mutations and 10 cases with HADH mutations).Conclusions When a child was admitted because of hypoglycemia,the diagnosis of protein-sensitive hypoglycemia should be suspected if he or she also had postprandial hypoglycemia,with or without hyperammonemia.Protein sensitivity test is helpful for us to make the diagnosis of protein-sensitive hypoglycemia.