Objective:To identify the change trajectory of intrinsic capacity in people aged ≥50 years in Shanghai and explore the impact of intrinsic capacity trajectory change on overall function and dalily life activities in this population.Methods:The longitudinal data from round 1 to 3 Study of Global Ageing and Adult Health in Shanghai were used. The total intrinsic ability scores from five dimensions of cognition, psychology, sensory, vitality and locomotion were calculated. The censored normal model of group-based trajectory was used to identify the trajectory of intrinsic capacity change over time. Linear regression model and multivariate logistic regression model were used to analyse the effects of different levels intrinsic capacity trajectory on the scores of the WHO Disability Assessment Schedule (WHODAS), the activity of daily living (ADL) and the instrumental activities of daily living (IADL).Results:A total of 2 302 study participants aged ≥50 years with 3 round complete data were included in this study, and 3 levels of intrinsic capacity trajectory were identified, low-level trajectory (9.3%), medium-level trajectory (41.7%), and high-level trajectory (49.0%). Compared with the high-level group, the medium-level and low-level groups had higher WHODAS scores, which increased by 3.578 (95% CI: 2.028-5.129) and 12.620 (95% CI: 9.951-15.289), respectively, and those with more severe disability and those in the low-level group were at higher risk for severe difficulty in ADLs ( OR=12.450, 95% CI: 4.310-35.966) and IADLs ( OR=5.479, 95% CI: 1.311-22.904). Conclusions:Heterogeneity in trajectory of intrinsic capacity exists in people aged ≥50 years in Shanghai. Middle-aged and elderly people with low initial level and rapid decline trajectory of intrinsic capacity are at greater risk for the decline of daily life ability and the increase of disability. It is necessary to strengthen the long-term dynamic monitoring and evaluation of the change trajectory of intrinsic capacity in this population.

The mother formula of Ruyizhenbao formula was the 25-flavor Zhumu Fang recorded in the Four Medical Codes,which was called Ruyi 25-flavor Zhumu Fang in the 16th century book Tibetan Medicine Ruyi Daquan.Later,in the book Qianwan Sheli,licorice was added to the formula,forming a 26-flavor basic formula of Ruyizhenbao.With the development of Tibetan medicine history,various doctors added and subtracted medicinal flavors to the basic formula.Finally,it was developed by Qinrenorbu into Ruyizhenbao formula composed of 30 herbs,which was published in the Treasure Source of Tibetan Medicine Secrets and was included in the Drug Standard of the Ministry of Health(Tibetan medicine)in 1995,becoming the formula standard of Ruyizhenbao formula.Through systematically sorting out Tibetan medicine literature from past dynasties,the formula name,medicinal taste composition,and changes of Ruyizhenbao formula recorded in different literature was comprehensively analyzed.Through primary literature research,the various claims about the origin of Ruyizhenbao formula published to date have been verified one by one to clarify its past and present,and to clarify its origin.The mother formula of Ruyizhenbao is the 25-flavor mother powder recorded in the Four Medical Codes.The basic formula is the Ruyizhenbao formula composed of 26 herbs in Qianwan Sheli,and the standard formula is the Ruyizhenbao formula composed of 30 herbs in the Treasure Source of Tibetan Medicine Secrets.

Objective:To identify the change trajectory of intrinsic capacity in people aged ≥50 years in Shanghai and explore the impact of intrinsic capacity trajectory change on overall function and dalily life activities in this population.Methods:The longitudinal data from round 1 to 3 Study of Global Ageing and Adult Health in Shanghai were used. The total intrinsic ability scores from five dimensions of cognition, psychology, sensory, vitality and locomotion were calculated. The censored normal model of group-based trajectory was used to identify the trajectory of intrinsic capacity change over time. Linear regression model and multivariate logistic regression model were used to analyse the effects of different levels intrinsic capacity trajectory on the scores of the WHO Disability Assessment Schedule (WHODAS), the activity of daily living (ADL) and the instrumental activities of daily living (IADL).Results:A total of 2 302 study participants aged ≥50 years with 3 round complete data were included in this study, and 3 levels of intrinsic capacity trajectory were identified, low-level trajectory (9.3%), medium-level trajectory (41.7%), and high-level trajectory (49.0%). Compared with the high-level group, the medium-level and low-level groups had higher WHODAS scores, which increased by 3.578 (95% CI: 2.028-5.129) and 12.620 (95% CI: 9.951-15.289), respectively, and those with more severe disability and those in the low-level group were at higher risk for severe difficulty in ADLs ( OR=12.450, 95% CI: 4.310-35.966) and IADLs ( OR=5.479, 95% CI: 1.311-22.904). Conclusions:Heterogeneity in trajectory of intrinsic capacity exists in people aged ≥50 years in Shanghai. Middle-aged and elderly people with low initial level and rapid decline trajectory of intrinsic capacity are at greater risk for the decline of daily life ability and the increase of disability. It is necessary to strengthen the long-term dynamic monitoring and evaluation of the change trajectory of intrinsic capacity in this population.

The mother formula of Ruyizhenbao formula was the 25-flavor Zhumu Fang recorded in the Four Medical Codes,which was called Ruyi 25-flavor Zhumu Fang in the 16th century book Tibetan Medicine Ruyi Daquan.Later,in the book Qianwan Sheli,licorice was added to the formula,forming a 26-flavor basic formula of Ruyizhenbao.With the development of Tibetan medicine history,various doctors added and subtracted medicinal flavors to the basic formula.Finally,it was developed by Qinrenorbu into Ruyizhenbao formula composed of 30 herbs,which was published in the Treasure Source of Tibetan Medicine Secrets and was included in the Drug Standard of the Ministry of Health(Tibetan medicine)in 1995,becoming the formula standard of Ruyizhenbao formula.Through systematically sorting out Tibetan medicine literature from past dynasties,the formula name,medicinal taste composition,and changes of Ruyizhenbao formula recorded in different literature was comprehensively analyzed.Through primary literature research,the various claims about the origin of Ruyizhenbao formula published to date have been verified one by one to clarify its past and present,and to clarify its origin.The mother formula of Ruyizhenbao is the 25-flavor mother powder recorded in the Four Medical Codes.The basic formula is the Ruyizhenbao formula composed of 26 herbs in Qianwan Sheli,and the standard formula is the Ruyizhenbao formula composed of 30 herbs in the Treasure Source of Tibetan Medicine Secrets.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree with 6q26q27 microduplication and 15q26.3 microdeletion. METHODS: A fetus with a 6q26q27 microduplication and a 15q26.3 microdeletion diagnosed at the First Affiliated Hospital of Wenzhou Medical University in January 2021 and members of its pedigree were selected as the study subject. Clinical data of the fetus was collected. The fetus and its parents were analyzed by G-banding karyotyping and chromosomal microarray analysis (CMA), and its maternal grandparents were also subjected to G-banding karyotype analysis. RESULTS: Prenatal ultrasound had indicated intrauterine growth retardation of the fetus, though no karyotypic abnormality was found with the amniotic fluid sample and blood samples from its pedigree members. CMA revealed that the fetus has carried a 6.6 Mb microduplication in 6q26q27 and a 1.9 Mb microdeletion in 15q26.3, and his mother also carried a 6.49 duplication and a 1.867 deletion in the same region. No anomaly was found with its father. CONCLUSION The 6q26q27 microduplication and 15q26.3 microdeletion probably underlay the intrauterine growth retardation in this fetus.
Female ; Humans ; Pregnancy ; East Asian People ; Fetal Growth Retardation/genetics* ; Karyotype ; Pedigree ; Prenatal Diagnosis ; Sequence Deletion ; Chromosome Duplication

OBJECTIVE： To study the efficacy and economics of cefoperazone/sulbactam combined with moxifloxacin and amikacin versus cefoperazone/sulbactam combined with tigecycline in the treatment of pneumonia with multidrug-resistant Acinetobacter baumannii （MDRAB）. METHODS： By prospective study， 150 MDRAB pneumonia patients were selected from Jingmen Second People’s Hospital during Jan. 1st， 2016-Aug. 31st， 2019， and then randomly divided into control group and observation group， with 75 cases in each group. Control group was given Cefoperazone/sulbactam sodium for injection （3 g， q8 h， ivgtt） combined with Tigecycline for injection （first dose 100 mg， maintenance dose 50 mg， q12 h， ivgtt）. Observation group  was give Cefoperazone/sulbactam sodium for injection （3 g， q8 h， ivgtt） combined with Moxifloxacin hydrochloride and sodium chloride injection （400 mg， qd， ivgtt） and Amikacin sulfate injection （0.6 g， qd， ivgtt）. The treatment lasted for 14 days in both groups. The time for body temperature to return to normal， lung rales disappearance， WBC to return to normal and PCT to return to normal， clinical efficacy， bacterial clearance rate and the occurrence of ADR were compared between 2 groups. Cost-effectiveness analysis was used to evaluate the cost- effectiveness ratio （C/E） and incremental cost-effectiveness ratio （ΔC/ΔE） of 2 groups using antibiotics cost as cost. Sensitivity analysis was performed by reducing drug cost by 15％. RESULTS： There was no statistical significance in the time for body temperature to return to normal， lung rales disappearance， WBC to return to normal and PCT to return to normal between control group and observation group （P＞0.05）. Clinical response rates of 2 groups were 85.33％ and 81.33％， and bacterial clearance rate were 89.33％ and 82.67％， with statistical significance （P＞0.05）. No serious ADR occurred in either group. The antibacterial cost of control group and observation group were 32 371.49 yuan/person and 9 367.82 yuan/person. C/E of clinical response rate were 379.37 and 115.18， and C/E of bacterial clearance rate were 362.38 and 113.32 in 2 groups， respectively. ΔC/ΔE of clinical response rate and bacterial clearance rate between control group and observation group were 5 750.92 and 3 454.00. Sensitivity analysis supported cost-effectiveness analysis results. CONCLUSIONS： Cefoperazone/sulbactam combined with moxifloxacin and amikacin versus cefoperazone/sulbactam combined with tigecycline in the treatment of pneumonia with MDRAB has similar efficacy， but cefoperazone/sulbactam combined with moxifloxacin and amikacin has economic and social benefits.

Objective To compare the efficacy and complications of the extend endoscopic endonasal approach (EEA) and open transcranial approach for resection of craniopharyngiomas. Methods The clinical data from 46 patients with craniopharyngiomas with extend EEA and 54 patients with transcranial route in our department was analyzed retrospectively. The gross total resection (GTR) rate,length of hospital stays and complications of the two groups were compared. Results The tumor diameters of were larger in the endoscopic group than in the transcranial group (3.5 ± 1.3cm vs. 3.0±0.8 cm, P<0.05). The endoscopic group had a greater GTR rate (67.4％vs. 46.3％, P<0.05)and improved visual outcome(84.2％ vs. 59.5％,P<0.05),but lower rate of hypopituitarism (56.5％ vs. 75.9％,P<0.05)and permanent diabetes insipidus (51.4％ vs.72.7％,P<0.05). On the contrast, the endoscopic group had a greater rate of cerebrospinal fluid leak(4.3％ vs. 0.0％,P>0.05)and longer hospital stays(17.0±3.6 d vs. 13.1±2.3 d,P<0.01). Hyposmia(34.8％)and hemorrhinia (2.2％)only happened in the endoscopic group. Conclusion Compared with transcranial route, the extend EEA for craniopharyngiomas is minimal invasion and effective, which can effectively improve the GTR rate and reduce the clinical symptoms.