Humans ; COVID-19/epidemiology* ; Pandemics ; SARS-CoV-2 ; Emergency Medical Services ; Emergency Treatment ; Emergency Service, Hospital

Objective:To investigate the efficacy of personalized family doctor contract services on risk factors of atherosclerotic cardiovascular disease (ASCVD) in high-risk population.Methods:Ten matched-community health centers of Shenzhen Luohu district were divided into intervention group and control group by cluster randomiztion. Subjects with high risks of ASCVD were screened out as intervention group from contracted residents who visited these centers and had complete data of the China-PAR model from August 2018 to April 2019. The control group received conventional general family doctor contract services. The individualized management were given to the intervention group after fully understanding patients′ ideas, concerns, and expectations (ICE). After 2-year intervention, score changes of ASCVD risk factors within and between groups were compared.Results:A total of 571 patients were enrolled, including 288 in the intervention group and 283 in the control group. After 2 years of intervention, 7 and 18 were lost to follow-up in two groups, respectively. Finally, 281 in the intervention group and 265 in the control group were included in the study. At baseline, there was no significant difference in ASCVD scores between the intervention group and the control group [(13.33±3.54) vs. (13.09±3.54) points; t=0.84, P=0.403], and the scores in both groups decreased significantly after the intervention [(10.89±4.01), (11.62±4.11) points], while the intervention group decreased more significantly (both P<0.05). Among the risk factors at baseline, HDL-C and diastolic blood pressure in the intervention group were lower than those in the control group, and there were no significant differences in other factors between the two groups. After the intervention, the levels of total cholesterol, systolic blood pressure and diastolic blood pressure in the two groups decreased significantly, and the number of people taking antihypertensive drugs increased significantly ( P<0.001 and P<0.05); HDL-C decreased in the control group ( P=0.023). After the intervention, compared to control group the intervention group had a higher proportion of patients taking antihypertensive drugs, with lower systolic and diastolic blood pressure ( P<0.05). After the intervention, the increase rate of HDL-C in the intervention group was more than that in the control group, and the decrease rate was less than that in the control group (χ 2=6.65, P=0.036). Conclusion:Family doctor contract services can reduce the risk factors of ASCVD, and personalized family doctor contract services can further improve the effects in the prevention and control of ASCVD. However, the effects might be insignificant and inconsistent for the ASCVD risk factors with deeper management requirements or no specific management measures, which highlights the complexity and diversity of ASCVD prevention and control, calling for multi-level and multi-faceted thinking and exploration.

Aged ; Cholecystectomy, Laparoscopic ; methods ; Cholelithiasis ; complications ; diagnosis ; surgery ; Clinical Laboratory Techniques ; Coronavirus Infections ; complications ; diagnosis ; Elective Surgical Procedures ; methods ; Follow-Up Studies ; Humans ; Infection Control ; methods ; Male ; Pandemics ; Patient Safety ; Pneumonia, Viral ; complications ; diagnosis ; Postoperative Care ; methods ; Risk Assessment ; Singapore ; Treatment Outcome

Objective: To explore the effects of noscapine (Nos) on the expression of cadherin 17 (CDH17) in colon cancer SW480 cells and the mechanism of Nos on cell migration. Methods: SW480 cells were divided into the control group, empty vector (si-EV) group, CDH17 interference (si-CDH17) group, Nos treatment group, and CDH17 interference+Nos treatment (si-CDH17+Nos) group. Small interfering RNA (siRNA) was used to knockdown CDH17, and the selected concentration of Nos was (55.30±2.21) µg/ml (IC50). The mRNA expression of CDH17 was detected by qPCR; the apoptosis and migration abilities of SW480 cells were observed by Hoechst33258 staining and Transwell assay; the contents of VEGF, MMP2 and MMP9 in SW480 cells were measured by ELISA, and the protein expressions of CDH17, Wnt3a and β-catenin were determined by WB. Results: Compared with the control group, mRNA and protein expressions of CDH17 obviously decreased, cell apoptosis and migration significantly reduced, while the contents of VEGF, MMP2 and MMP9 as well as the protein expressions of Wnt3a and β-catenin significantly decreased in Nos treatment group, siCDH17 group and si-CDH17+Nos treatment group (all P<0.01).The effect of si-CDH17+Nos treatment was more significant than that of si-CDH17 (P<0.01). Conclusion: Nos induces apoptosis and inhibits the migration of human colon cancer SW480 cells, which may be related to the down-regulation of CDH17 expression and inhibition of the Wnt3a/β-catenin signaling pathway.

Objective To investigate the effect of quantitative ultrasound bone mineral density test on the screening of osteoporosis in patients with knee osteoarthritis and to explore the relationship between knee osteoar-thritis and osteoporosis. Methods 160 patients with knee osteoarthritis were divided into 4 groups:Ⅰ,Ⅱ,ⅢandⅣby Kellgren-Lawrence and measured height,weight,age,quantitative ultrasound bone mineral density and dual energy X-ray bone density.We compared the T values measured by quantitative ultrasound bone mineral density test and dual energy X-ray bone density,assessed the accuracy of quantitative ultrasound bone mineral density test for osteoporosis,and investigated the correlation between the value of quantitative ultrasound bone mineral density and knee osteoarthritis in different grades. Results Quantitative ultrasound bone mineral density was positively correlated with dual energy X-ray bone density(r = 0.751,P < 0.05). The AUC of diagnosis of osteoporosis by quantitative ultrasound bone mineral density test with T<-2.5 was 0.774,95% CI was 0.676 and 0.791,specificity was 96.7%,sensitivity was 85.7% and Youden index was 82.4%.With an increase in the grades of Kellgren-Law-rence,the knee osteoarthritis gradually worsened.The T values of quantitative ultrasound bone mineral density and dual energy X-ray bone density increased gradually in negative direction,and the difference was statistically signifi-cant(P<0.001).Conclusions Quantitative ultrasound bone mineral density test has good specificity and sensi-tivity and can be used to screen patients with knee osteoarthritis. The more severe the knee osteoarthritis is,the easier to develop osteoporosis.

OBJECTIVETo optimize the protocols for isolation and culture of mesenchymal stem cells from rat bone marrow (BMSCs).

METHODSBMSCs were isolated by adherence to plastic with frequent medium change and reduced trypsinization time. The cell growth curves were drawn and the surface markers of BMSCs were detected by flow cytometry. The cells were induced to differentiate into osteogenic, adipogenic, hepatic and cholic lineages.

RESULTSThe cells isolated using this method were positive for CD29, CD44, and CD90 and negative for the hematopoietic surface markers CD45. The osteogenic and adipogenic differentiation of the BMSCs was verified by alkaline phosphatase staining, Alizarin red staining and Oil red staining. The cell subcultures up to passage 10 maintained capacities of differentiation into osteogenic and adipogenic lineages. The BMSCs induced with sequential addition of growth factors, cytokines and hormones differentiated into cells expressing hepatocyte- and cholangiocyte-specific markers.

CONCLUSIONThe optimized method allows efficient isolation of homogenous populations of MSCs from rat bone marrow, which can be induced into multiple cell lineages.

This study was aimed to offer a scientific basis for the differentiation and control quality of Castanea mol-lissima Blume shell. The determination was given from the morphological identification, microscopical identification and TLC identification. The results showed that through obtained information such as morphological traits, tissue powder and TLC characteristics, the longitudinal section micrographs of C. mollissima Blume shell and the micro-scopic images of tissue powder had been received. It was concluded that the study provided a reliable reference for the identification of the quality control standards of C. mollissima Blume shell.

This report highlights the rare occurrence of a huge gangrenous Meckel's diverticulum in an adult, which was managed successfully with laparoscopic resection. A 45-year-old woman presented with a one-day history of right iliac fossa pain with fever and vomiting. Computed tomography showed a huge gangrenous Meckel's diverticulum. The patient underwent laparoscopic exploration and extracorporeal stapled resection of the Meckel's diverticulum. This case serves to highlight the safety and feasibility of performing a laparoscopic resection of a huge gangrenous Meckel's diverticulum in an adult.
Female ; Gangrene ; diagnostic imaging ; surgery ; Humans ; Laparoscopy ; Meckel Diverticulum ; diagnostic imaging ; surgery ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

The arterial lesions of lower extremities in patients with diabetic foot ulcers were extensive.The majority of below-knee arteries showed severe stenosis, even complete occlusion.Interventional therapy of femoral artery was effective in improving arterial blood perfusion and remission of the pain and numbness.After therapy, the skin temperature and ankle brachial index (ABI) were increased, healing of ulcer was enhanced and intermittent claudication was ameliorated.Percutaneous transluminal angioplasty of femoral artery was effective in improving arterial blood perfusion of the lower extremities with foreseen curing efficacy.

Objective To observe the effect of intraaortic balloon pump (IABP) on tolerance of percutaneous coronary intervention (PCI), life signs of patients with acute myocardial infarction (AMI) during emergency PCI performed.Methods46 AMI patients complicated with or without cardiogenic shock were put on IABP at same time of coronary angiography when emergency PCI performed, and tolerance of PCI, blood pressure, heart rate and immediate death rate of patients were observed before and after operation.Results45 cases had IABP successful and 1 case failed. 40 patients (86.96%) could endure whole emergency PCI process, the total death rate was 10.87%. 66.67% of patients with obvious cardiogenic shock could endure emergency PCI, the death rate was 33.33%; 94.12% of patients without cardiogenic shock could endure PCI treatment and the death rate was 2.94%. 35 cases completed PCI treatment and the successful rate was 85.36%.ConclusionPCI supported by IABP can prevent AMI patients from cardiogenic shock, ease symptoms of patients complicated with cardiogenic shock, improve the tolerance and successful rate of the PCI treatment, and decrease immediate death rate.