Osteoporosis is common in elderly population.The risk of falls and bone fractures in elderly patients with osteoporosis are closely related to the elderly syndrome[1].This article introduces the coexistence of osteoporosis and geriatric syndrome,which will limit the functional independence of patients and lead to more complex medical man-agement.Osteoporosis has some association with common geriatric syndromes,and patients with osteoporosis are more likely to suffer from more geriatric syndromes,and their quality of life and prognosis are worse.This article re-views epidemiological status,influencing factors and management strategies of osteoporosis comorbid with geriatric syndrome,aiming to provide a basis for the integrated management of osteoporosis.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been reapproved for heart failure (HF) therapy in patients with and without diabetes. However, the initial glucose-lowering indication of SGLT2i has impeded their uses in cardiovascular clinical practice. A challenge of SGLT2i then becomes how to separate their anti-HF activity from glucose-lowering side-effect. To address this issue, we conducted structural repurposing of EMPA, a representative SGLT2 inhibitor, to strengthen anti-HF activity and reduce the SGLT2-inhibitory activity according to structural basis of inhibition of SGLT2. Compared to EMPA, the optimal derivative JX01, which was produced by methylation of C2-OH of the glucose ring, exhibited weaker SGLT2-inhibitory activity (IC₅₀ > 100 nmol/L), and lower glycosuria and glucose-lowering side-effect, better NHE1-inhibitory activity and cardioprotective effect in HF mice. Furthermore, JX01 showed good safety profiles in respect of single-dose/repeat-dose toxicity and hERG activity, and good pharmacokinetic properties in both mouse and rat species. Collectively, the present study provided a paradigm of drug repurposing to discover novel anti-HF drugs, and indirectly demonstrated that SGLT2-independent molecular mechanisms play an important role in cardioprotective effects of SGLT2 inhibitors.

Objective : To compare the clinical characteristics of ordinary and severe coronavirus disease 2019 ( COVID-19 ) cases, so as to provide basis for the diagnosis, treatment and prognosis. Methods : We recruited 77 COVID-19 cases in Wenzhou Central Hospital from January 15 to February 29, 2020, collected their general information, clinical symptoms, laboratory test and CT scan results, and compared the clinical features of ordinary and severe cases. Results: There were 50 ordinary cases and 27 severe cases. The age, prevalence of hypertension and other baseline diseases of severe cases were higher than those of ordinary cases ( P<0.05 ) . The maximum body temperature during 1-3 days of hospitalization, proportion of body temperature rising, prevalence of cough, yellow phlegm, hemoptysis, chest tightness and shortness of breath of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The proportion of pulmonary consolidation, glazing and patch shadow, the number of solid changes and the cumulative number of lesions of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The values of LYM during 1-10 days of hospitalization, total T-lymphocyte percentage, CD4 count and percentage, CD8 count, Hb and oxygenation index of severe cases were lower than those of ordinary cases; while the values of LDH and NLR during 1-10 days of hospitalization, N8R, AST, ferritin, CRP during 1-7 days of hospitalization and D-dimer of severe cases were higher than those of ordinary cases ( all P<0.05 ). Conclusions Severe COVID-19 cases have older age, higher prevalence of baseline diseases, fever, shortness of breath symptoms, more lung consolidation and lesions, significantly decreased lymphocyte level ( especially CD4 ) , and increased LDH, NLR, ferritin and CRP.

Objective To explore the influential facts of betel quid chewing for patients with oral submucous fibrosis (OSF) in Haikou,Hainan Province.Methods One hundred and twenty three patients in the Haikou City People's hospital were investigated regarding their clinical information,including age,sex,origins,kinds and time of betel nut chewing,obvious clinical features,cognition for its harmfulness and so on.Results (1)The mean age was 36.5 years old,the most common patients were the group between the ages of 30 and 50 among 123 patients,male preferred to chewing betel nut,the female fond of betel nut were mostly Li minority women.(2)People chewing the dry betel nut had the higher incidence than the ones who prefer the fresh in five years.The both were significant difference (x2 =18.79,P ＜0.01),however,the incidence difference between the patients at the same time and the ones chewing kinds of betel nut was not significant (P ＞ 0.05).(3)The early clinical features of some OSF patients included stimulating pain,mucosal blanching,gradual inability to open the mouth and fibrous bands.(4)Although 61 patients (49.59％) knew about the harmfulness of betel nut chewing for their oral health,they could not change their lifestyle.Conclusions Male prefers to chewing betel nut,the female fond of betel nut are mostly Li minority women in Haikou area,the parts of patients could not overcome the habit ofchewing betel nut; people chewing the dry betel nut has the higher incidence than the ones who prefer the fresh's at early period,and of the two the former prone to disease than the latter.

Objective To analyze the efficacy and cosmetic results of intensity modulate radiation therapy (IMRT) for breast cancer after breast-conserving surgery.Methods From 2003 to 2006, 117 patients with breast cancer, after breast-conserving surgery followed by 4 - 6 cycles of chemotherapy,received intensity modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3DCRT).The radiation dose was 50 Gy in 25 fractions to the whole breast and 10 Gy boost to the tumor bed.Patients with positive hormone receptors then received endocrine treatment.Results The follow-up rate was 94.0% until September 2009.114 and 91 patients were followed up to 3 and 5 years, respectively.The 3-and 5-year overall survival rates were 99.1% and 96%.The 5-year disease free survival and local recurrence rates were 88% and 3.6%.Cosmetic results were satisfied.Severe radiation toxicities, such as radiation pneumonitis, pulmonary fibrosis and heart injury were not found.Conclusions Patients treated with IMRT after breast-conserving surgery have a satisfied prognosis as well as cosmetic results.