Objective:To develop a prediction tool for 6-year incident risk of frailty among Chinese older adults aged 65 years or above.Methods:Data from the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2018 was used, including 13 676 older adults aged 65 years or above who were free of frailty at baseline. Key predictors of frailty were identified via the least absolute shrinkage and selection operator (LASSO) method, and were thereafter used to predict the incident frailty based on the Cox proportional hazards regression model. The model was internally validated by 2 000 Bootstrap resamples and evaluated for the performance of discrimination and calibration using the area under the receiver operating characteristic curve (AUC) and calibration curve, respectively. The net benefit of the developed prediction tool was evaluated by decision-curve analysis.Results:The M( Q1, Q3) age and follow-up time of the participants were 81.0 (71.0, 90.0) years and 6.0 (4.1, 9.2) years, respectively. A total of 4 126 older persons (30.2%) were recorded with frailty incidents during the follow-up, with the corresponding incidence density of 41.8/1 000 person-years. A total of 15 key predictors of frailty were selected by LASSO, namely, age, sex, race, education years, meat consumption, tea drinking, performing housework, raising domestic animals, playing cards or mahjong, and baseline status of visual function, activities of the daily living score, instrumental activities of the daily living score, hypertension, heart disease, and self-rated health. The prediction model was internally validated with an AUC of 0.802, with the max Youden's index of 0.467 at a risk threshold of 19.0%. The calibration curve showed high consistency between predicted probabilities and observed proportions of frailty events. The decision curve indicated that higher net benefits could be obtained via the prediction model than did strategies based on intervention in all or none participants for any risk threshold less than 59%, and the model-based net benefit was estimated to be 0.10 at a risk threshold of 19.0%. Conclusions:The herein developed 6-year incident risk prediction model of frailty, based on easily accessible questionnaires and physical examination variables, has good predictive performance. It has application potential in identifying populations at high risk of incident frailty.

Trib. Lorantheae used as traditional Chinese materia medica has a long history. There are 41 genera of Trib. Lorantheae， of which 6 belong to China， all have medicinal value， mainly distributed in Southwest， Southern， and Central and Southern China， with abundant resources. Twenty-two species of Trib. Lorantheae are used as medicinal materials or herbs in China. It mainly includes Taxillus. chinensis， T. sutchuenensis， Scurrula parasitica， Loranthus tanakae， Dendrophthoe pentandra， S. ferruginea， etc.， of which T. chinensis is the most widely used. The main chemical components of Trib. Lorantheae include flavonoids， terpenoids， sterols， phenylpropanoids， curcumins， phenolic acids， violate oils， sugars， and other compounds. Modern studies show that the extracts and monomer compounds of Trib. Lorantheae have various pharmacological effects such as anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， bacteriostasis， anti-virus， and lowering blood sugar， blood pressure， and lipid. It is believe that most active components related to their pharmacological effects are flavonoids， most of which are the main pharmacodynamic substances of the parasitic plants of Trib. Lorantheae， playing an important role in anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， and other pharmacological effect. This paper systematically summarized the literature and data on plants of Trib. Lorantheae and reviewed their chemical components and pharmacological effects， which provided references for the research， development， and utilization of Trib. Lorantheae.

Objective:To explore the serum levels of copper and zinc and the application value of the ratio in assessing disease activity in patients with inflammatory bowel disease (IBD).Methods:From March 2019 to April 2020, 200 patients with IBD hospitalized at the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University were selected by prospective random direct sampling method, including 100 patients with Crohn′s disease (CD) and 100 patients with ulcerative colitis (UC). The Crohn′s disease activity index (CDAI) and the modified Mayo score were used to evaluate the disease activity of CD patients and UC patients. In the same period 100 healthy individuals in the routine physical examination were selected as healthy control group. The serum levels of copper and zinc of the healthy control group, the CD group and the UC group were determined by atomic absorption spectrometry. The levels and the ratio of serum copper to zinc of three groups were compared. The ratio of serum copper to zinc of CD patients and UC patients with different disease activity were compared. The correlation between the ratio of serum copper to zinc and IBD activity indexes were analyzed, which included fecal calprotectin (FC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), CDAI and Mayo score. Receiver operating characteristic curve was drawn to analyze the value of the ratio of serum copper to zinc, CRP and ESR in predicting disease activity of patients with IBD. Independent sample t test, least significant difference- t test and Pearson correlation analysis were performed for statistical analysis. Results:The serum copper levels and the ratio of serum copper to zinc of the CD group and the UC group were both higher than that of the healthy control group, however the serum zinc levels were lower than that of the healthy control group ( (32.27±7.69) and (29.80±9.68) mol/L vs. (20.16±6.67) mol/L; 2.81±1.57 and 2.29±1.09 vs. 0.68±0.36; (14.64±7.11) and (15.65±8.17) mol/L vs. (34.29±16.40) mol/L), and the differences were statistically significant ( t=2.81, 5.87, 1.47, 7.21, 1.73 and 2.56, all P<0.05). Among CD patients, the the ratio of serum copper to zinc of patients at remission stage (29 cases), mild activity stage (23 cases), moderate activity stage (30 cases) and severe activity stage (18 cases) was 2.61±1.43, 2.75±1.35, 3.15±2.37 and 4.17±1.77, respectively, and the ratios of serum copper to zinc of patients at mild activity stage, moderate activity stage and severe activity stage were all higher than that of patients at the remission stage, and the differences were statistically significant ( t=3.41, 7.92 and 5.84, all P<0.05). There were statistically significant differences in the ratios of serum copper to zinc between patients at mild activity stage and moderate activity stage, severe activity stage, and between patients at moderate activity stage and severe activity stage ( t=5.82, 6.23 and 3.45, all P<0.05). Among UC patients, the ratio of serum copper to zinc of patients at remission stage (10 cases), mild activity stage (30 cases), moderate activity stage (45 cases) and severe activity stage (15 cases) was 1.52±0.44, 1.74±0.58, 2.38±0.83 and 3.80±1.19, respectively, the ratio of serum copper to zinc of patients at moderate activity stage was higher than that of patients at remission stage and mild activity stage, and the ratio of serum copper to zinc of patients at severe activity stage was higher than those of patients at remission stage, mild activity stage and moderate activity stage, and the differences were statistically significant ( t=7.92, 5.83, 3.21, 9.54 and 2.83, all P<0.05). There was no statistically significant difference in serum copper to zinc ratio between patients at remission and at mild activity stage ( P>0.05). The ratio of serum copper to zinc of CD patients was positively correlated with FC and CRP ( r=0.697 and 0.586, P=0.014 and 0.001), however was not correlated with ESR or CDAI score (both P>0.05). The ratio of serum copper to zinc of UC patients was positively correlated with FC, ESR and Mayo score ( r=0.488, 0.452 and 0.331, P=0.001, P<0.01 and P=0.041), however was not correlated with CRP ( P>0.05). The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of CD activity was 1.76, 8 mg/L and 20 mm/1 h, respectively. Among them, ESR was the most effective in the diagnosis of CD activity with an area under the curve (AUC) value of 0.830, and to the sensitivity and specificity was 69.0% and 86.2%, respectively. The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of UC activity was 1.63, 8 mg/L and 20 mm/1 h, respectively; among which the the ratio of serum copper to zinc had the highest efficacy in the diagnosis of UC activity, with an AUC value of 0.862, sensitivity and specificity of 73.0% and 90.9%, respectively. Conclusion:The the ratio of serum copper to zinc is correlated with the disease activity of IBD, which may become a new auxiliary indicator for the evaluation of disease activity.

In order to evaluate the intervention effect of the school-based salt reduction model, 28 primary schools were selected in Shandong Province in September 2014 and randomly divided into intervention group (1 361 students, 1 306 parents) and control group (1 364 students,1 340 parents). A series of "small hands and big hands" salt reduction intervention activities were conducted in intervention group for 8 months. After the intervention, the total awareness rate of salt reduction knowledge, the total holding rate of related beliefs and the total reporting rate of related behaviors were 70.65%, 80.30% and 67.03% among students, and 85.66%, 93.77% and 87.93% among parents, in the intervention group, which were higher than those in the control group (37.12%, 66.52% and 50.07% among students; 55.11%, 87.52% and 57.96% among parents) (all P values <0.05). The school-based salt reduction model is effective and feasible.

Objective: To evaluate the feasibility and safety of magnetic tracer technique for preoperative endoscopic marking in laparoscopic surgery. Methods: In the preliminary study, a total of 8 patients with gastric (n=3) or colorectal (n=5) tumors underwent endoscopic magnetic marking before laparoscopic surgery from April to June in 2019. First, a magnet was attached to the lesion by 2 titanium clips under the endoscope. Second, during the subsequent laparoscopic operations, the other magnet was sent to the vicinity of the lesion through the laparoscopic tunnel. The magnet in the abdominal cavity was quickly attracted to the one in the gastrointestinal tract to successfully locate the lesions. Data of preoperative marking and operations of 8 patients were reviewed. Results: All 8 lesions were marked successfully, rapid and accurate intraoperative positioning was achieved. The mean time of endoscopic marking was 5.75±2.45 minutes, and the mean time of intraoperative localization was 1.94±0.56 minutes. All patients underwent laparoscopic tumor resections with accurate localization. The mean proximal and distal resection margins of colorectal tumors were 105 mm and 74 mm respectively. No complications occurred. Conclusion Magnetic tracer technique for laparoscopic localization, simple, safe and accurate for gastrointestinal lesions, can be performed without additional equipment or endoscopic procedures involved.

In order to evaluate the intervention effect of the school?based salt reduction model, 28 primary schools were selected in Shandong Province in September 2014 and randomly divided into intervention group (1 361 students, 1 306 parents) and control group (1 364 students,1 340 parents). A series of "small hands and big hands"salt reduction intervention activities were conducted in intervention group for 8 months. After the intervention, the total awareness rate of salt reduction knowledge, the total holding rate of related beliefs and the total reporting rate of related behaviors were 70.65%, 80.30% and 67.03% among students, and 85.66%, 93.77% and 87.93% among parents, in the intervention group, which were higher than those in the control group (37.12%, 66.52% and 50.07% among students; 55.11%, 87.52% and 57.96% among parents) (all P values<0.05). The school?based salt reduction model is effective and feasible.

In order to evaluate the intervention effect of the school?based salt reduction model, 28 primary schools were selected in Shandong Province in September 2014 and randomly divided into intervention group (1 361 students, 1 306 parents) and control group (1 364 students,1 340 parents). A series of "small hands and big hands"salt reduction intervention activities were conducted in intervention group for 8 months. After the intervention, the total awareness rate of salt reduction knowledge, the total holding rate of related beliefs and the total reporting rate of related behaviors were 70.65%, 80.30% and 67.03% among students, and 85.66%, 93.77% and 87.93% among parents, in the intervention group, which were higher than those in the control group (37.12%, 66.52% and 50.07% among students; 55.11%, 87.52% and 57.96% among parents) (all P values<0.05). The school?based salt reduction model is effective and feasible.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

Objective To explore the aortic remodeling after thoracic endovascular aortic repair for acute type stanford B aortic dissection. Methods Retrospective analysis the clinical data of 51 patients who diagnosed with acute type B aortic dis-section and received TEVAR between September 2015 and August 2016. The maximal diameters of false and true lumen were measured directly at the level of primary tear entry, the level of the bronchial bifurcation,and the level of the celiac trunk and the the lower edge of left renal artery,changes in diameter were evaluated between the preoperative and postoperative CT scan. Results The marked change in the true lumen dilatation and false lumen regression trend at the level of primary tear entry after thoracic endovascular repair(1 month vs 1 year, P<0. 05), while the changes of its diameter above level were not obvious af-ter thoracic endovascular repair(3 months vs 6 months, P>0. 05). the true lumen dilatation and false lumen regression trend at the level of the bronchial bifurcation along with time. The true lumen dilatation is a process of slow change at the level of the celiac trunk and the lower edge of left renal artery after TEVAR, and the false lumen changed not obviously. Conclusion En-dografting is effective for acute type B aortic dissection which can promote positive descending aortic remodeling changes,but it has no significant effect on abdominal aortic remodeling.

Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.