Objective:To analyze the trend of premature death of non-communicable diseases (NCDs) in Wuxi from 2008 to 2018 and evaluate the influence of premature mortality probability caused by four main NCDs on life expectancy.Methods:Based on the mortality data collected by Wuxi Mortality Registration System and the population data collected by Wuxi Public Security Bureau during 2008-2018, this study analyzes the trend of the probability of premature death on malignant tumors, cardiovascular and cerebrovascular diseases, chronic respiratory diseases, and diabetes. The impact on life expectancy was analyzed by using the methods of abridged life table, Joinpoint regression, and life expectancy contribution decomposition.Results:From 2008 to 2018, the total probability of premature death of four main NCDs in Wuxi were declined consistently from 11.25% to 9.25% (AAPC = -2.0%, 95% CI: -2.6--1.5), higher in female (from 7.74% to 5.91%) than that in male (from 14.49% to 12.51%). The Wuxi resident's life expectancy increased by 1.86 years (from 78.66 to 80.52 years), in males and 1.26 years (from 83.85 to 85.11 years) in females, respectively. The decline of premature death of malignant tumors, cardiovascular and cerebrovascular diseases and chronic respiratory system diseases had a positive contribution to life expectancy, which contributed 0.34 years (23.90%), 0.15 years (10.50%), and 0.03 years (2.36%) to the life expectancy growth, respectively. Among which, premature death of cardiovascular and cerebrovascular diseases in men aged 40-55y had a negative contribution to life expectancy (-0.04 years). The probability of premature death of males with diabetes was on the rise (AAPC = 7.1%, 95% CI: 2.8-11.6), which negatively contributed to life expectancy for both males and females, reducing life expectancy by 0.03 years (-2.14%) in Wuxi. Conclusion:The premature death probability of four main NCDs in Wuxi declined consistently from 2008 to 2018, which played a positive role in the growth of life expectancy. Compared with females, males had a higher premature death probability and a slower rate of decline. More intervention and health management of premature male death on cardiovascular and cerebrovascular diseases and diabetes should be conducted to improve life expectancy further.

Objective:To assess the effectiveness of peer-supported diabetes self-management group intervention and explore a community-based diabetes health management model.Methods:From September to December in 2016, patients with type 2 diabetes were recruited from 6 streets (townships) in Binhu and Xishan district of Wuxi, Jiangsu Province. According to a structured diabetes self-management course, guidance was provided by community health workers and peer volunteers. Self-management group intervention was led by type 2 diabetes patients. A self-control design was used to collect information on self-management behavior, fasting blood glucose, and health care utilization at baseline and after 4-month intervention, and compare the difference of these indicators before and after the intervention.Results:Compared with the baseline, 147 participants aged from 30 to 80 years old had more increases in proportions of salt control (78.2% vs 60.5%, P<0.001) and oil control (79.6% vs 58.5%, P<0.001) in daily diet. The P50 ( P25, P75) of scores of symptom management and consultation list increased from 6 (0, 11) and 0 (0, 2) to 9 (4, 13) and 1 (0, 2) ( P<0.05) after 4-month intervention. Fasting blood glucose significantly decreased from (8.8±2.9) mmol/L at baseline to (7.6±1.9) mmol/L and the control rate of blood glucose significantly increased from 29.3% to 44.2% ( P<0.05) after 4-month intervention. The proportion of outpatient visited decreased from 42.2% to 12.9% and the proportion of hospitalized decreased from 10.2% to 4.1% ( P<0.05) after 4-month intervention. Conclusion:Peer-supported diabetes self-management group intervention could effectively improve behavior and blood glucose control of patients with type 2 diabetes.

Objective:To assess the effectiveness of peer-supported diabetes self-management group intervention and explore a community-based diabetes health management model.Methods:From September to December in 2016, patients with type 2 diabetes were recruited from 6 streets (townships) in Binhu and Xishan district of Wuxi, Jiangsu Province. According to a structured diabetes self-management course, guidance was provided by community health workers and peer volunteers. Self-management group intervention was led by type 2 diabetes patients. A self-control design was used to collect information on self-management behavior, fasting blood glucose, and health care utilization at baseline and after 4-month intervention, and compare the difference of these indicators before and after the intervention.Results:Compared with the baseline, 147 participants aged from 30 to 80 years old had more increases in proportions of salt control (78.2% vs 60.5%, P<0.001) and oil control (79.6% vs 58.5%, P<0.001) in daily diet. The P50 ( P25, P75) of scores of symptom management and consultation list increased from 6 (0, 11) and 0 (0, 2) to 9 (4, 13) and 1 (0, 2) ( P<0.05) after 4-month intervention. Fasting blood glucose significantly decreased from (8.8±2.9) mmol/L at baseline to (7.6±1.9) mmol/L and the control rate of blood glucose significantly increased from 29.3% to 44.2% ( P<0.05) after 4-month intervention. The proportion of outpatient visited decreased from 42.2% to 12.9% and the proportion of hospitalized decreased from 10.2% to 4.1% ( P<0.05) after 4-month intervention. Conclusion:Peer-supported diabetes self-management group intervention could effectively improve behavior and blood glucose control of patients with type 2 diabetes.

Objective To investigate D-Dimer, C-reactive protein and brain natriuretic peptide in clinical diagnosis of patients with pulmonary embolism and to compare the sensitivity, specificity and accuracy.Methods 45 cases of large area pulmonary embolism and 45 cases of small areapulmonary embolism were selected, at the same time, 45 cases of normal people were selected as the control group.D-dimer, CRP and BNP levels were detected and compared of each group before and after treatment.The relevance between D-Dimer, CRP, BNP levels and pulmonary embolism was analyzed by Logistic analysis.The gold standard of pulmonary embolism with D-dimer test, CRP test and BNP test were compared.the sensitivity, specificity and accuracy ofD-dimer test, CRP test and BNP test wer calculated.Results D-Dimer, CRP and BNP levels of the large area group and small area group were significantly higher than those in the control group before treatment (P<0.05);the D-Dimer, CRP and BNP levels of large area group were significantly higher than those in small area group (P<0.05).After treatment, the D-Dimer, CRP and BNP levels of large area group and small area were significantly decreased (P<0.05), and had no significant difference compared with normal control group.Logistic analysis showed that there was significant positive correlation between plasma, D-Dimer, CRP and BNP levels and pulmonary embolism (r=3.11, P<0.05;r=4.36, P<0.05;r=2.86, P<0.05) .There was no significant difference of sensitivity, specificity and accuracy of three methods.Conclusion There is a positive correlation between the occurrence of pulmonary embolism and D-dimer, CRP, BNP levels, which are important indexs to evaluate the patient's condition, it has very important clinical value.

Objective To observe and compare the atomic force microscopy (AFM) images of Yersinia pestis EV76 and the changes in the morphology of the bacteria treated with normal serum and F1 antibody from rabbit,and to explore the immunoassay method to detect Yersinia pestis by AFM. Methods The Yersinia pestis were treated with normal serum and F1 antibody from rabbit and control buffer. All the prepared samples were observed and analyzed by AFM. The changes in the cell surface structures were probed and characterized through sectional analysis,especially the changes of Ra and Rq value. Results The normal morphology of Yersinia pestis was oval in shape with a relatively smooth surface, the size dimension of which was about 1.1-1.3 μm in length with a section profile of 0.8-1.0 μm in width and 0.04-0.06 μm in step height. The step height of the bacteria treated with the normal serum and F1 antibody was obviously enlarged. The shape of the bacteria treated with F1 antibody changed irregularly. Furthermore, the surface of the bacteria was more roughened. Conclusion The morphological characters of Yersinia pestis has been acquired through its AFM images. The morphology of Yersinia pestis treated with F1 antibody has changed greatly, and the index of roughness can be regarded as the distinguished index to detect Yersinia pestis by AFM.

Objective To explore the features of echocardiographic partial anomalous pulmonary venous connection (PAPVC) with intact interatrial septum. Methods Three patients with intact interatrial septum of PAPVC were examined by transthoracic echocardiography (TTE) using HP Sonos 5500 color Doppler machine. Imaging was performed at a frequency of 2～4 MHz, or 12 MHz. Results Accuracy of the diagnosis by TTE was 100 %. The patients had isolated PAPVC. The connection site was the coronary sinus in two, right atrium in one. There was a single anomalous connection vein in one patient, two in the others. Apparent right heart dilation was found in all the patients. Conclusion Unexplained right heart volume overload that was examined by TTE should have a high-degree suspicion for PAPVC. The origin site of pulmonary veins and their flow should be examined routinely. Transesophageal echocardiography (TEE) and TTE are complementary in the diagnosis.

Objective To study the ultrasound-guided treatment by real-time biplane imaging in animals and patients. Methods In 6 dogs gallbladders were substituted as hepatic cysts. The shapes of gallbladders and spatial positions of needle tips in gallbladders were studied by real-time biplane imaging before and during treatments. During treatments of 3 renal cysts the changes of cysts and the spatial relations between needle tips and renal cysts were observed to confirm that the needle tips were always in the cysts. In 2 cases of hepatocellular carcinoma boiloff of the tissue around the antenna was observed by real-time biplane imaging during microwave coagulation. Results It was rapid and convenient to acquire the shape information of objects and locate the position of puncture by real-time biplane imaging. And it was more convenient to observe the spatial relation between needle tips and objects of treatment than by conventional single-plane imaging. Conclusions The method of real-time biplane imaging has great advantages in ultrasound-guided treatment.

Objective To study the velocity pattern of ischemic myocardium change during systolic phase by Doppler tissue imaging(DTI). Methods Twenty-three dogs were investigated as two groups. In 13 open-chest dogs as group A, regional wall motion abnormalities were induced by occluding branches of left circumflex coronary arteries(LCX). Left ventricular(LV) wall systolic velocity patterns at the mid-wall portion of the middle of LV posterior walls in the short-axis direction were recorded with DTI before and after artery occlusion. Ten dogs as group B were operated to occlude branches of LCX. Before and one week after operation the same parameters were recorded by transthoracic method. Results There were positive velocity peak(IVC 1), negative velocity peak(IVC 2) during isovolumic contraction and positive velocity peak(S) during ejection in DTI spectra of all normal LV posterior walls. The peak velocities of IVC 1 and S decreased significantly, but the peak velocity of IVC 2 increased significantly after occluding branches of LCX in both groups (P

Objective To investigate the feasibility of gene delivery to the ischemic myocardium of rabbits by ultrasound-mediated destruction of microbubbles. Methods A ligation model of left circumflex branch coronary artery was established in 48 rabbits. Three days after ligation, the mixture of gene and microbubbles was infused into the vein of rabbits with or without simultaneous ultrasound. Additional controls included ultrasound of microbubbles that did not contain gene, gene alone, gene plus ultrasound,and blank control. Rabbits were killed after two weeks and examined for the expression of vascular endothelial growth factor(VEGF). Results The hearts of five rabbits that underwent ultrasound-mediated destruction of microbubbles containing gene showed VEGF expression in ischemic myocardium.None of the control animals showed VEGF expression. Conclusions Ultrasound-mediated destruction of microbubbles is a promising method for the delivery of bioactive agents to the heart.

Objective To study the effects of ultrasound mediated microbubbles destruction on endothelial cells transfected with lipofectamine DNA complexes.Methods One hour after addition of pIRES2 EGFP hVEGF gene and lipofectamine,endothelial cells on 6 well plates were exposed to ultrasound for 30 s,60 s,or 90 s in the presence(10 ?l,100 ?l,500 ?l) or absence of ultrasound contrast agent.The transducer (Sonos 5500,S3, 1.3 MHz,MI 1.0 ) was submerged in water and held at a distance of 1 cm.Expression of the marker gene EGFP was observed by fluorescent microscopy 2 days later.Results Ultrasound treatment of endothelial cells on plates for 30 s and 60 s yielded significant increase in transfection rates without damaging the cells,but 90 s treatment killed most of the cells.Ultrasound contrast agent was able to significantly increase endothelial cells transfection rate by enhancing cavitation effects at a concentration of 100 ?l,and damaged most cells when applied at a concentration of 500 ?l.Conclusions Ultrasound mediated destruction of microbubbles enhances gene expression after lipofectamine mediated transfection of endothelial cells in vitro; and it may represent an improved avenue for therapeutic gene delivery in vivo.