Objective: To investigate the trends in mortality and life loss due to falls among the elderly in Wenzhou City, Zhejiang Province, so as to provide the basis for formulating prevention and control measures for falls among the elderly. Methods: The data on fall-related deaths among the elderly aged 60 and above in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2015 to 2023. The crude mortality was calculated and standardized using the data from the Sixth National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL), average years of life lost (AYLL), and potential years of life lost rate (PYLLR). The trends in mortality and life loss among the elderly were analyzed using the annual percent change (APC) and average annual percent change (AAPC). Results: There were 11 378 deaths due to falls among the elderly in Wenzhou City from 2015 to 2023, with a crude mortality of 82.67/100 000 and a standardized mortality of 65.32/105, which appeared no significant changing trend (AAPC=3.401%、2.995%,both P>0.05). There was a tendency towards a rise from 2019 to 2023 (APC=12.592%、11.507%, both P<0.05). The majority of falls occurred at home, with 6 312 cases accounting for 55.48%. The primary types of fall-related deaths were slips, trips, and falls on the same level, with 8 541 cases representing 75.07%. The crude mortality and standardized mortality of falls in males were 76.63/105 and 60.86/105, which were lower than that in females at 88.72/100 000 and 70.33/100 000 (both P<0.05), and the trends were consistent with the overall population. The crude mortality of falls among the elderly increased with age (P<0.05). From 2015 to 2023, the crude mortality of falls among the elderly aged 60 to <65 years showed an upward trend (AAPC=4.860%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). The PYLL was 5 123 person-years, the AYLL was 0.45 years per person, and the PYLLR was 0.37‰. From 2015 to 2023, PYLL showed an upward trend (AAPC=5.477%, P<0.05). The PYLL, AYLL, and PYLLR for males were 3.08 times, 3.48 times, and 2.67 times those of females, respectively. Conclusions From 2015 to 2023, the mortality of falls among the elderly in Wenzhou City had remained relatively stable. However, PYLL showed an upward trend. Males and older seniors were key groups for falls prevention. It is recommended to enhance health education and promote age-friendly home modifications to prevent falls among the elderly.

【Objective】 To explore the molecular hereditary and frequency of Jk(a-b-) in blood donors in Yichang. 【Methods】 A total of 49 999 samples from Yichang Red Cross Central Blood Station were screened for Jk(a-b-) by urea hemolysis test(2 mol /L). The phenotypes of JK (a-b -) probands and their families were confirmed by monoclonal anti-Jk^a and anti-Jk^b, and the whole exon of SLC14A1 gene was sequenced. 【Results】 The frequency of Jk(a-b-) in Yichang blood donors was 0.004% (2/49 999), and the exon sequencing of SLC14A1 gene confirmed that both two probands were JK^*02N.01 caused by c. 342-1G>A homozygous mutation.Besides, JK^*01W.01 allele was observed in the pedigree analysis, and weak expression of Jk^a was found in 4 out of 11 family members. 【Conclusion】 The frequency of JK (a-b -) in Yichang blood donors is similar to those in Shanghai 0.004%(2/48 400), and both caused by JK ^* 02N.01 allele with high frequency in Southeast Asia. The epidemiological survey of JK ^* 01w.01 allele frequency should be further performed.

Objective:To summarize critical cases of emergency helicopter transferring between hospitals and improve the quality and safety of critical care.Methods:The task records of Guangxi Aviation Medical Rescue Training Base from September 2017 to September 2020 were retrieved. The mission acceptance, implementation results, disease spectrum composition, pre-transfer preparation and medical intervention on board were summarized.Results:① General information: a total of 168 patients of helicopter transfer requests were registered, of which 36 patients were transferred, 35 patients were successful, 1 patient had cardiac arrest during the landing phase, and died several hours after continuous resuscitation. Of the 36 patients 30 were males and 6 were females, with median age of 50.5 (29.8, 66.0) years old, the average transfer time was (54.95±17.89) minutes, and the average transfer distance was (205.74±74.68) km. ② Disease spectrum included 11 cases of stroke (30.55%), 7 cases of trauma (19.45%), 5 cases of severe pneumonia (13.89%), 5 cases of heart and macro-vascular diseases (13.89%), 5 cases of abdominal emergency (13.89%), and 3 other conditions (8.33%).③ Severity: 31 patients (86.11%) were severe (≥15) according to acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score; 19 patients (52.78%) were high-risk emergency transport (≥6) according to Hamilton early warning score (HEWS); 6 patients (85.71% of trauma patients) were severe trauma (≥16) according to injury severity score (ISS). ④ Preparation before transfer: remote consultation was carried out to evaluate the latest state of the patient's condition, especially the respiratory and circulatory conditions. Relevant items were reviewed and emergency treatments were implemented when necessary. Targeted preparation was made for accidents that might occur during transfer, such as electrocardiogram (94.44%), blood gas analysis (94.44%), brain CT (36.11%) and other auxiliary examinations, endotracheal intubation or tracheotomy (72.22%), deep vein catheterization (91.67%), placement of gastric tube (86.11%) and urinary tube (88.89%), adjustment of sedative (38.89%), vasoactive drugs (58.33%) and drugs for dehydration and lowering intracranial pressure (33.33%), and fixation of fracture (11.11%), etc. ⑤ On-board medical intervention: cardiac monitoring, blood pressure, respiration and blood oxygen monitoring were carried out in all patients. The parameters of patients using ventilator were adjusted in time (66.67%). The dosage of patients using micropump was adjusted in time (91.67%). Other aspects included the use of sedative and analgesics (38.89%), sputum suction nursing (75.00%), all kinds of catheter nursing (endotracheal intubation/incision nursing of 72.22%, indwelling catheter nursing of 88.89%), and cardiopulmonary resuscitation for patient with cardiac arrest (2.78%).Conclusion:As the patients transferred by helicopter are mainly those of critically ill at this stage, the requirements for airborne medical equipment and rescue technology are high, and there is an urgent need to establish technical specifications and personnel training standards.

OBJECTIVE:To investigate the effects of acarbose combined with metformin on related indexes of patients with type 2 diabetes mellitus.METHODS:A total of 100 patients with type 2 diabetes mellitus were randomly divided into control group (50 cases) and observation group (50 cases).Control group was given Acrbose tablet 50 mg orally,3 times a day.Observation group was additionally given Metformin hydrochloride tablet 0.5 g orally,3 times a day,on the basis of control group.Both groups were treated for 12 weeks.The levels of fasting plasma glucose (FPG),fasting plasma insulin (FINS),glycosylated hemoglobin (HbA1c),2 h postprandial plasma glucose (2 hPG),postprandial 2 h insulin (2 hFINS),insulin resistance index (HOMA-IR),the proportion of Th cell subsets in CD4+ T cells,IL-22,IL-17A and IFN-γ,mRNA expression of IL-22,IL-17A and IFN-γ were observed in 2 groups before and after treatment.The occurrence of ADR was recorded.RESULTS:After treatment,FPG,FINS,HbA1c,2 hPG,2 hFINS,HOMA-IR,the proportion of Th cell subsets in CD4+ T cells,the concentrations of IL-22,IL-17A and IFN-γ,expression of IL-22 mRNA,IL-17A mRNA and IFN-γ mRNA in 2 groups were significantly lower than before treatment,with statistical significance (P＜0.05);there was no significant difference in the proportion of Th1 in T cells between 2 groups (P＞0.05).Other indexes of observation group were significantly lower than those of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:For patients with type 2 diabetes mellitus,acarbose combined with metformin can effectively control the level of blood glucose,improve insulin resistance,balance Th cell subsets,reduce inflammatory factors levels but don't increase the occurrence of ADR.

Objective To introduce a new spinal surgery navigation system based on structured light scanning(structured light navigation system,SLNS),and to compare accuracy of pedicle screw placement using SLNS,CT based navigation system and free hand technique.Methods Thirty-two calf vertebral pedicles,40 and 32 were placed with pedicle screws using SLNS,CT navigation system,and free hand technique,respectively.The pedicle breakage ratio,transverse section angle (TSA),sagittal section angle (SSA),screw offset deviation of each screw were detected according to CT images.Results The pedicle breakage ratio of pedicle screws in SLNS group,CT navigation group and free hand group were 6%(2./32),5%(2/40),25%(8/32),respectively.The difference between each of the two navigation groups and free hand group were statistically significant regarding frequency of screw misplacement.The difference between the two navigation systems was not obvious.The average SSA error and TSA error in SLNS group were 2.58°±2.74° and 4.26°±5.20°.For CT navigation group,they were 2.95°±2.61° and 3.13°±-2.75°.There was no statistical difference between the two navigation methods for the SSA or TSA error.There was no statistical difference in offset deviation among SLNS group,CT navigation group and free hand group.Conclusion The SLNS is a new and practical navigation system,which has similar accuracy with CT navigation system.

Objective To explore the effects of mulitinational united medical transport of emergency and critical patients in Indonesia after earthquake tsunami disaster.Method Various factors,which affected mulitinational united medical transport in Indonesia after earthquake tsunami disaster were analyzed.Results All of the 217 emergency and critical patients were successfully transported to the destination.Conclusion Mulitinational united medical rescue had advantages on integrating medical resources and improving efficiency.During mulitinational united medical transport,the tasks should be distributed rationally,and self-protection of medical workers was the basis of accomplishing medical rescue.

The support vector machine (SVM) is a new learning technique based on the statistical learning theory. It was originally developed for two-class classification. In this paper, the SVM approach is extended to multi-class classification problems, a hierarchical SVM is applied to classify blood cells in different maturation stages from bone marrow. Based on stepwise decomposition, a hierarchical clustering method is presented to construct the architecture of the hierarchical (tree-like) SVM, then the optimal control parameters of SVM are determined by some criterion for each discriminant step. To verify the performances of classifiers, the SVM method is compared with three classical classifiers using 3-fold cross validation. The preliminary results indicate that the proposed method avoids the curse of dimensionality and has greater generalization. Thus, the method can improve the classification correctness for blood cells from bone marrow.
Algorithms ; Blood Cells ; classification ; Cluster Analysis ; Computational Biology ; methods ; Humans ; In Vitro Techniques ; Least-Squares Analysis ; Models, Biological ; Nonlinear Dynamics

A hybrid segmentation algorithm is proposed for automatic segmentation of blood cell images based on adaptive multi-scale thresholding and seeded region growing techniques. Firstly, an adaptive and scale space filter (ASSF) is applied to image histogram and a scale space image is built. According to the properties of the scale space image, proper thresholds can be obtained to separate the nucleus from the original image and the white blood cells are located. Secondly, the local color similarity and global morphological criteria constrain seeded region growing in order to finish the segmentation of the cytoplasm. The detection accuracy of white blood cell is 98% and the segmentation accuracy based on the subjective evaluation is 93%. Test shows that this algorithm is effective for automatic segmentation of white blood cells.
Algorithms ; Automation ; Blood Cells ; Cell Nucleus ; ultrastructure ; Color ; Cytoplasm ; ultrastructure ; Humans ; Image Enhancement ; Leukocytes