Objective:To understand residents' health status and disease characteristics by analyzing the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020, thus providing scientific evidence for disease prevention and treatment.Methods:Information on the first page of inpatient medical records from 77 secondary or higher-level hospitals was provided by the Tianjin Health and Medical Big Data Platform.The codes of the International Classification of Diseases 10th revision(ICD-10)were used by the system for standardized diagnoses at hospital discharge.The disease spectrum of inpatients was analyzed based on the systems implicated by diseases.Age stratification was performed in examining changes in the orders of diseases across the spectrum.Results:Between 2018 and 2020, a total of 3 568 034 patients were discharged, with 1 204 733 in 2018, 1 372 747 in 2019, and 990 554 in 2020.Male patients accounted for 49.2%(1 756 867/3 568 034), elderly patients(65 years or older)accounted for 33.5%(1 194 189/3 568 034), and patients from tertiary hospitals accounted for 86.5%(3 085 482/3 568 034).According to the ICD-10, there were 19 categories of diseases when diagnoses at discharge were considered.Over the three-years period, the top ten diseases made up 81.1%(2 893 430/3 568 034)of all cases at discharge, with high consistency in their rankings(harmonic index value Wa=0.986, χ2=70.989, P<0.001).The circulatory system and the nervous system always occupied the top two positions, while the respiratory system decreased from third to seventh place in 2020.The rankings of factors affecting health and healthcare access increased.The circulatory system, nervous system, respiratory system, digestive system, and tumors consistently ranked among the top six categories in the disease spectrum of the elderly and the rankings of diseases related to the eye, ear, endocrine system, musculoskeletal system, and connective tissue system were also up compared to those of the entire population. Conclusions:Hospitalized patients are concentrated in tertiary hospitals, with a relatively high proportion of elderly patients.In the disease spectrum, circulatory system diseases, neurological system diseases, digestive system diseases, tumors, and respiratory system diseases have always been at the top of the list for medical treatment, both for the entire population and for elderly patients, with a significant decrease in the ranking of respiratory system diseases in 2020.The rankings of eye, ear, endocrine, musculoskeletal, and connective tissue diseases in elderly patients have increased compared to the entire population, indicating a need to step up the development of geriatric medicine and related specialties and the importance to promote the healthy China initiative and healthy aging.

Objective:To investigate the mechanism of tripartite motif-containing 27 (TRIM27) expression promoting inflammatory response in non-small lung cancer cells.Methods:Ten cases of lung cancer tissues and their matched normal tissue (the distance was 5 cm of the tumor marginal) from patients underwent resection in the People′s Hospital of Pingyang Hospital Affiliated to Wenzhou Medical University were collected. The expression of TRIM27 was identified by using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot. TRIM27 knockdown experiment included negative control (NC TRIM27) group, TRIM27 short interfering RNA (siRNA) group, NC TRIM27+ TNF-α group and TRIM27 siRNA+ TNF-α group. Interlukin-6 (IL-6) knockdown experiment included NC IL-6 group and IL-6 siRNA group. The protein expressions of TRIM27, TNFR1, TNFR2 and some TNFR related inflammation factors were verified by qRT-PCR and WB. Results:The expression levels of TRIM27 in NSCLC tissues of different stages (stage Ⅰ: 2.81±0.58, stage Ⅱ: 3.32±1.38, stage Ⅲ: 3.67±1.24) was higher than that in the adjacent normal tissues (1.01±0.15, 0.92±0.10 and 1.05±0.12, P<0.05). The expression levels of TRIM27 mRNA in NC TRIM27 group and NC TRIM27+ TNF-α group were 0.94±0.12 and 1.67±0.03, and the expression levels of TRIM27 protein were 0.31±0.02 and 0.38±0.01, respectively ( P<0.05). The expression levels of IL-6 mRNA in NC TRIM27+ TNF-α group and TRIM27 siRNA+ TNF-α group were 11.35±0.12 and 5.62±0.15, respectively, and the expression levels of VCAM-1 mRNA were 18.75±0.17 and 9.35±0.11, respectively. STAT3 mRNA expression levels were 16.54±0.10 and 8.12±0.10, respectively, with statistical significance ( P<0.05). The expression levels of IL-6 mRNA in NC IL-6 group and IL-6 siRNA group were 1.10±0.07 and 0.52±0.16, respectively, and the expression levels of STAT3 mRNA were 1.01±0.01 and 0.48±0.12, respectively. The expression levels of TRIM27 mRNA were 1.03±0.01 and 0.30±0.11, respectively, with statistical significance ( P<0.05). Conclusion:The upregulation of TRIM27 in NSCLC tissue and cells promotes the expression of TNF-α, and may activate inflammatory response by regulating TNF-α-induced IL-6/STAT3 signaling pathway.

Objective:To investigate the mechanism of tripartite motif-containing 27 (TRIM27) expression promoting inflammatory response in non-small lung cancer cells.Methods:Ten cases of lung cancer tissues and their matched normal tissue (the distance was 5 cm of the tumor marginal) from patients underwent resection in the People′s Hospital of Pingyang Hospital Affiliated to Wenzhou Medical University were collected. The expression of TRIM27 was identified by using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot. TRIM27 knockdown experiment included negative control (NC TRIM27) group, TRIM27 short interfering RNA (siRNA) group, NC TRIM27+ TNF-α group and TRIM27 siRNA+ TNF-α group. Interlukin-6 (IL-6) knockdown experiment included NC IL-6 group and IL-6 siRNA group. The protein expressions of TRIM27, TNFR1, TNFR2 and some TNFR related inflammation factors were verified by qRT-PCR and WB. Results:The expression levels of TRIM27 in NSCLC tissues of different stages (stage Ⅰ: 2.81±0.58, stage Ⅱ: 3.32±1.38, stage Ⅲ: 3.67±1.24) was higher than that in the adjacent normal tissues (1.01±0.15, 0.92±0.10 and 1.05±0.12, P<0.05). The expression levels of TRIM27 mRNA in NC TRIM27 group and NC TRIM27+ TNF-α group were 0.94±0.12 and 1.67±0.03, and the expression levels of TRIM27 protein were 0.31±0.02 and 0.38±0.01, respectively ( P<0.05). The expression levels of IL-6 mRNA in NC TRIM27+ TNF-α group and TRIM27 siRNA+ TNF-α group were 11.35±0.12 and 5.62±0.15, respectively, and the expression levels of VCAM-1 mRNA were 18.75±0.17 and 9.35±0.11, respectively. STAT3 mRNA expression levels were 16.54±0.10 and 8.12±0.10, respectively, with statistical significance ( P<0.05). The expression levels of IL-6 mRNA in NC IL-6 group and IL-6 siRNA group were 1.10±0.07 and 0.52±0.16, respectively, and the expression levels of STAT3 mRNA were 1.01±0.01 and 0.48±0.12, respectively. The expression levels of TRIM27 mRNA were 1.03±0.01 and 0.30±0.11, respectively, with statistical significance ( P<0.05). Conclusion:The upregulation of TRIM27 in NSCLC tissue and cells promotes the expression of TNF-α, and may activate inflammatory response by regulating TNF-α-induced IL-6/STAT3 signaling pathway.

Objectives To reveal the association between Helicobacter pylori infection and creatinine clearance rate in elderly patients with hypertension.Methods A total of 600 elderly hypertensive patients with different degrees of renal impairment and helicobacter pylori(HP)infection were randomly selected from Department of Health Care,General Hospital of Tianjin Medical University from 2010 to 2015.Serum creatinine concentration detection was conducted and creatinine clearance rate was calculated.Patients were divided into HP infection group(n =254)and non-HP-infection group (n =346).The multiple logistic regression analysis showed the correlation between Helicobacter pylori infection and decreased creatinine clearance rate.Results Creatinine clearance rate was significantly lower in HP-infection group[(61.1 ± 12.7)ml/min] than in non-HP-infection group[(78.5 ± 11.9) ml/min,P =0.014].Multifactorial logistic analysis revealed that Helieobacter pylori infection was significantly associated with decreased creatinine clearance rate(OR=3.5 18,95 ％ CI:1.105～4.918,P =0.011).Conclusions Helicobacter pylori infection is significantly related with decreased creatinine clearance rate in elderly patients with hypertension.

Objective To investigate the changes of microglia cell phenotypes in the injured brains of rats following repetitive mild traumatic brain injury (rmTBI).Methods Sixty male SD rats were randomly divided into sham-operated group,injury of one-week group,injury of two-week group,injury of four-week group,and injury of six-week group (n=12).Rats in the injury groups were induced rmTBI models by controlled cortical impact (CCI),and rats in the sham-operated group were only performed bone window opening without hitting.Six rats from each group were sacrificed;immunofluorescent staining was used to detect the Iba-1 positive microglial cells in the injured cortex and changes ofmicroglia subsets in the injured brain after rmTBI were analyzed by flow cytometry.Results As compared with the sham-operated group,the injury of one-week group and injury of six-week group had significantly increased percentages of Iba-1 positive microglial cells in the injured cortex (19％ and 12％,P＜0.05).flow cytometry indicated that CD451ow/CD11b+ cells were the microglial cells,accountting for 90％ ofCD11b+ cells;as compared with the sham-operated group,the injury of one-week group,injury of two-week group,injury of four-week group,and injury of six-week group had significantly increased M1 type microglial cells (P＜0.06),with injury of six-week group enjoying the highest level;as compared with the sham-operated group,the injury of one-week group,injury of two-week group and injury of four-week group had significantly increased M2 type microglial cells (P＜0.06),with injury of two-week group enjoying the highest level.Conclusion Dynamic changes ofmicroglia subsets after rmTBI are noted,which reveals that different subsets of microglia phenotypes might play their unique roles in the acute or chronic phases after rmTBI.

Objective To study the cognitive impairment in SD rats after intermittent hypoxia (IH),and explore the relation of miR-26b up-regulated expression and neuron apoptosis in the hippocampus of SD rats after IH.Methods Eight-week-old male SD rats (n=20,each weighing approximately 300±10 g) were randomly divided into normal oxygen control group,IH 1-week group,IH 2-weeks group and IH 4-weeks group (n=5).Rats in the later three groups were given IH for different times,and rats in the normal oxygen control group were given normal oxygen.The spatial learning and memory abilities were detected by Morris Water Maze (MWM) in the normal oxygen control group and IH 4-weeks group.The levels of apoptosis proteins Caspase3 and Bax and anti-apoptosis protein Bcl-2 in the hippocampus of 4 groups were detected by Western blotting.The miR-26b expression level in the 4 groups was detected by real time-PCR.Results (1) The results of MWM revealed that the mean escape latency in the IH 4-weeks group was significantly prolonged as compared with that in the normal oxygen control group (P＜0.05);the time entering into the target quadrant in the IH 4-weeks group ([22.0±6.7] s) was significantly shorter than that in the normal oxygen control group ([39.8±8.8] s,P＜0.05).(2) Western blotting indicated that up-regulated expressions of apoptosis proteins Bax and Casepase3 and down-regulated expression of anti-apoptosis protein Bcl-2 in the IH 1-week group,IH 2-weeks group and IH 4-weeks group were noted as compared with those in the control group,with significant differences (P＜0.05);significantly higher apoptosis protein Bax and Casepase3 expressions in the IH 1-week group were noted as compared with those in the IH 2-weeks group and IH 4-weeks group (P＜0.05),while significantly decreased Bcl-2 expression in the IH 1-week group was noted as compared with that in the IH 2-weeks group and IH 4-weeks group (P＜0.05).(3) The results of real time-PCR revealed that the miR-26b expression level in the hippocampus was up-regulated in the IH 1-week group,IH 2-weeks group and IH 4-weeks group as compared with that in the control group,with significant differences (P＜0.05);miR-26b expression level in the IH 1-week group was significantly higher as compared with that in the IH 2-weeks group and IH 4-weeks group (P＜0.05).Conclusion The miR-26b up-regulated expression in the hippocampus might refer to Bax /Bcl-2-related mitochondrial apoptotic signaling pathway after IH brain injury;miR-26b could be a potential mean ofgene therapy after IH brain injury.

Objective To explore the establishment of a rabbit model of atrial fibrillation by wireless telemetering and stimulation technology.Method An implantable telemetering stimulator which was independently designed and devel-oped was hypodermically implanted in New Zealand rabbits.The implantable telemetering stimulator was made with the core development and design of MSP single-chip microcomputer of TI Corporation ( Texas Instruments) and RF wireless trans-ceiver chip CC2250 of TI Corporation.The design of the implantation system was optimized to cater to the exploratory ex-periment to establish atrial fibrillation model of New Zealand rabbits.The implanter was implanted into the abdominal sub-cutaneous tissue of the New Zealand rabbits, the collecting electrodes were placed in the oxter subcutaneous tissues of the left and the right upper extremities, and the two stimulating electrodes were sutured at the left auricle and the left atrium. The signals were collected and stimulated by the wireless transceiver.The I-lead ECG electrical signals were continuously monitored on the body surface by a Powerlab physiological recorder.High frequency ( >20 Hz) suprathreshold stimulus ( intensity 2 mA, pulse width 1 ms) was emitted by specialized stimulation software of a computer program by the interval ( stimulating for 2 s and pausing for 2 s) .In case of atrial fibrillation during intervals, the stimulation could be stopped by hand.In case of sinus rhythm, the stimulation could be continued.Results The implantable telemetering stimulator can work stably in vivo ( including collecting stimulated electrocardio signal and emitting stimulations) for 30 days.Atrial fibril-lation can be induced after stimulating in vivo of the New Zealand rabbits for 3 weeks, with a duration of >48 h.Conclu-sions Applying implantable telemetering stimulator can build a New Zealand istead of beagles model of atrial fibrillation which is more consistent with welfare optimization and substitution principle for laboratory animals.

Objective To compare laparoscopic appendectomy to conventional operation for the treatment of appendicitis.Methods In this study 1558 patients diagnosed as appendicitis were divided into group A(laparoscopic appendectomy)and group B(conventional operation)according to the random numbers.In group A,779 patients were treated with laparoscopic appendectomy.In group B,779 patients were treated with conventional open appendectomy.The inhospital data and that of followed-up were compared.Statistical analysis was carried out using SPSS11.5 for Windows.Comparisons between categorical variables and continuous variables were analyzed using the X~2 test and t test.Results The operation was successfully performed in all 1558 patients.The operating time in group A and B were(30±2.2)min versus(30±1.6)min(t=0.00,P>0.05),the blood loss were(15±2.9)ml versus(29±5.2)ml(t=65.62,P<0.05),the bed off activity time were(26±3.1)h versus(51±2.1)h(t=69.95,P<0.05),the bowels'move time were(29±1.6)h versus(52±4.6)h(t=10.92,P<0.05),the hospital stay were(3±0.9)d versus(7±1.2)d(t=74.42,P<0.05),the inhospital cost was (6591±41)yuan versus(4860±32)yuan(t=-12.19,P<0.05),the incision infection rate was 0 and 2.8%(X~2=25.40,P<0.05).Postoperative analgesics were needed in 3.8% and 31.4% (X~2=30.63,P<0.05).All the patients were followed-up from 4.5 years to 9.8 years(average 6.8 years).The development of incision hernia in group A and B was 0 versus 0.64% (X~2=5.01,P<0.05).Conclusions Laparoscopic appendectomy is a therapy of choice for patients with acute appendicitis with advantages of minimal invasion,early recovery,few complications and short hospital stay.

Objective To study the safety and efficacy of laparoseopic subtotal thyroidectomy for primary hyperthyroidism.Methods From January 2003 to January 2007,seventy-five patients with primary hyperthyroisism underwent subtotal thyroidectomy,among which thirty patients by laparoscopic procedure and forty-five patients by open surgery.The clinical data were retrospectively analyzed.Results All the surgery were Successful.No patient in the endoscopic group was converted to open surgery.The mean operative times of endoscopic group and open surgery group were(110.5±12.3)min vs(98.8±15.5)min(t=3.46,P<0.05),the mean blood loss were(45.5±11.5)ml vs(65.8±12.6)ml(t=7.07,P<0.05),the inhospital fee were(11128.5±358.8)RMB yuan vs(6500.9±231.9)RMB yuan(t=67.92,P<0.05),the amount of drainage were(125.9±10.7)ml vs(46.5±9.4)ml(t=33.90,P<0.05),the days of drainage were(2.98±0.5)d vs(1.75±0.3)d(t=13.31,P<0.05),tlle use of analgeties was in 20.0%(6/30)vs 42.2%(19/45)(χ~2=4.00,P<0.05),the rate of temporary hoarseness wag 6.6%(2/30)vs 8.8%(4/45)(χ~2=0.12,P>0.05).There were 1 hypothyroidism and 1 recurrent hyperthyroidism in endoscopic group while 1 hypothyroidism and 2 recurrent hyperthyroidism in open surgery group after a 47.8 month's follow-up. Conclusions Endoscopic subtotal thyroideetomy for hyperthyroidism patients is safe,effective and presents a significant cosmetic advantage.

Objective To study the efficiency of iaparoscopic inguinal hernia repair without the use of a mesh. Methods We used laparoscopic hernia repair without the use of a mesh in 92 cases of inguinal hernia. Results were compared with that of total extraperitoneal laparoscopic inguinal hernioplasty(TEP) in 91 cases from January 2001 to March 2004. Results The laparoscopic procedures were successfully performed in all the patients. In mesh-free and TEP group respectively the operating time was (21±4) min vs. (70±16) min (t=28. 01, P<0.05), hospital stay was (3.5±1.0) d vs. (4.8±1.2) d (t=7.96, P<0.05), average time off-bed was (1.0±0.5) d vs. (1.8±0.7) d (t=8.90, P<0.05), duration of pain was (1.0±0.5) d vs. (2.5±0.7) d (t=16.69, P<0.05), the expense was (4500±500) RMB yuan vs. (8000±820) RM B yuan(t=34.89, P<0.05), subcutaneous hematoma rate was 0% vs. 8.7% (χ~2=6.48, P<0.05). The 48 hour C-reaction protein level after the operation was (3.9±0.3) mg/dl and (8.8±0.5) mg/dl (t=80.48, P<0.05). All the difference was statistically significant between the two groups. All patients were followed up for 56.9±6.2 months. The recurrence rate was 0 and 2.1% (χ~2=0.51,P>0.05) respectively. Conclusions Mesh-free laparoseopie inguinal hernia repair is safe, cost-effective, as well as of much lower hernia recurrence.