ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables. ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）. ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.

Objective:To investigate health status and calculate health life expectancy (HE) of residents in Shanghai, analyze health related factors and provided foundation of health policy.Methods:A multi-stage stratified random sampling was used to obtain self-reported health survey in Shanghai. WHO questionnaire was used to evaluate the health quality of life which was designed for the world health survey, Sullivan's method was used to calculate HE.Results:The self-assessment disability measure for adults over 18 years old in Shanghai was 0.25, higher for women (0.28) than for men (0.23). LE was 65.76 years for adults over 18 years old, higher for women (68.22) than for men (63.39). HE for adults over 18 years old was 47.99 years old, higher for men (49.05) than women (47.14). HE's proportion in LE gradually decreases with age. It accounts for 72.97% in the 18 years old and 39.00% in the 85 years old.Conclusions:The health of adult male in Shanghai is higher than that of female, and the proportion of HE loss of elderly is higher than young people. It is necessary to focus on the aging problem and strengthen the long-term care and health support system for the elderly. Improve the prevention and control of major diseases such as chronic diseases,which affect the quality of life expectancy seriously. Promotes the health level and quality of life in Shanghai.

OBJECTIVE: To explore the value of BACs-on-Beads (BoBs) for the practice of prenatal diagnosis. METHODS: The results of chromosomal karyotyping and BoBs of 1773 prenatal samples were compared. Microdeletions and microduplications detected by BoBs were subjected to chromosome microarray analysis (CMA) with informed consent from patients. RESULTS: BoBs has detected 46 cases of common aneuploidies involving chromosomes 13, 18, and 21, and 16 cases involving X and Y chromosomes. For 4 fetuses with normal results by BoBs, karyotyping analysis of amniotic fluid sample suggested low percentage mosaicisms (< 20%). BoBs has detected none of the 9 common microdeletions, but 14 male fetuses with Xp22 microdeletions and 5 with other microdeletions/microduplications. In 10 cases, the couples had chosen CMA verification, and the results were all consistent. CONCLUSION As a rapid diagnostic technique, BoBs has a high accuracy for common aneuploidies, and is capable of discovering certain chromosome microdeletions and microduplications. The difficulty lies in the inability to detect low proportion mosaicisms and the consultation following detection for male fetuses carrying Xp22 microdeletions.

Objective:To summarize the clinical characteristics and treatment of pituitary thyrotropin mixed secreting adenoma.Methods:The clinical data of 9 patients with pituitary thyrotropin mixed secreting adenoma from January 2008 to December 2019 in Beijing Tiantan Hospital, Capital Medical University, were retrospectively analyzed.Results:Among 9 patients, male was in 7 cases, and female in 2 cases; age was (35.7 ± 13.5) years; course of disease was (3.8 ± 3.1) years; mixed thyrotropin and growth hormone secreting adenoma was in 6 cases; most of them were accompanied with different degrees of thyrotoxicosis, 6 with acromegaly and 2 with amenorrhea and lactation. All the tumors were pituitary macroadenoma, with aggressive growth. Only 1 patient was completely relieved after operation, and most patients needed combined treatment to control the disease.Conclusions:Mixed thyrotropin and growth hormone secreting adenoma is the most common type of the disease, the clinical manifestations are complex, and the tumor is aggressive growth, surgical treatment can not be completely relieved and radiotherapy and/or combination of medicine treatment can help to improve the condition.

Objective:To explore the differences of attention bias performance between patients with heroin dependence in methadone maintenance treatment(MMT) and healthy controls.Methods:A total of 38 heroin dependent patients in the Fourth People's Hospital of Huainan from January 2018 to September 2018 were selected as MMTgroup, and 32 gender-and age-matched healthy controls were selected as healthy control(HC) group.The attention bias was evaluated by Emotional Stroop Task, and the difference between the two groups was compared.Results:The error number of the herion-related words in Emotional Stroop Task of MMT group was lower than that of HC group[0.75(2, 5) vs.1(0, 2)], the difference was statistically significant( Z=-2.184, P=0.029). The number of errors in point and neutral words and reaction time of point, neutral word and clue word had no statistically significant differences between MMT group and HC group[1(0, 4) vs.1(0, 2); 3(2, 5) vs.2(2, 3); (1 055.14±303.50)ms vs.(985.40±173.71)ms, (1 126.89±347.82)ms vs.(1 022.76± 173.62)ms; (1 188.53±371.80)ms vs.(1 113.23±225.11)ms]( Z=-1.331, P=0.183; Z=-1.723, P=0.085; t=1.150, P=0.254; t=1.539, P=0.129; t=1.001, P=0.320). There were no statistically significant differences in attention bias influenced by the dosage and duration of methadone between MMT group and HC group(all P>0.05). Conclusion:These results demonstrate that heroin dependence patients in MMT have attentional bias in heroin-related words.Methadone has no effect on attention bias in patients with heroin dependence during maintenance treatment intervention.

Objective To observe and analyze the effect of different external fixation methods on catheter related urinary tract infection (CAUTI).Methods The clinical data of 86 patients suffered from indwelling catheters were retrospectively analyzed .According to the different external fixation of indwelling catheter , the patients were divided into observation group (n=43) and control group (n=43).The control group received drainage tube fixed in the bedside the legs go below ,the observation group received drainage tube fixed on the bed after upper thigh walking . The incidence of complications was analyzed in the two groups .Results The incidence rates of CAUTI ,leakage of urine,skin indentation of the observation group were 13.95％,6.98％ and 2.33％,respectively,which were lower than those of the control group (34.88％,30.23％ and 23.26％),there were statistically significant differences between the two groups (χ2 =11.869,17.848,19.630,all P<0.05).The incidence rates of 2,3 degree pain and pain in the observation group were 0.00％,4.65％,6.98％,respectively,which in the control group were 2.33％, 6.98％,9.30％,respectively,the differences were not statistically significant (χ2 =2.357,0.495,0.359,all P>0.05).Conclusion For the patients of indwelling catheter ,drainage tube is fixed on the bed by the upper thigh walking is helpful to reduce skin pressure , reduce catheter infection and urine leakage rate , and can improve the comfort degree of patients ,it is worthy of clinical popularization and application .

Objective To investigate the relationship between renal vascular resistance index( RI) and serum Apelin level in type 2 diabetic mellitus ( T2DM )?Methods Seventeen cases newly diagnosed T2DM patients with RI increased but without microalbuminuraia in Minhang Hospital Affiliated to Fudan University from December 2011 to December 2014 were selected as observation group,17 newly diagnosed T2DM patients with RI normal during the same period were selected as control group?Fasting plasma glucose(FPG),glycosylated hemoglobin A1C(HbAlC),blood lipids and fasting insulin(FINS),hepatic functional and renal function were tested in all the subjects?Serum Apelin level was detected by enzyme?linked immunosorbent assay?Results Compared with control group,serum Apelin level was significantly higher in observation group((179?2±122?4)μg/L vs?(56?7±50?6) μg/L,t=3?814,P<0?05)?Partial correlation analysis showed that the RI was positive correlated with Apelin ( r= 0?364, P= 0?040 )?Conclusion The serum Apelin levels elevated in newly diagnosed T2DM patients with RI increased, and RI is positively correlated with Apelin, which indicate that Apelin play an important role in the pathophysiology of early renal damage in patients with TsDM.

Objective To investigate the expression changes of macrophage migration inhibitory factor( MIF) and C-Jun N-terminal kinase ( JNK) in the liver of rat with abnormal glucose metabolism and explore the pathological mecha-nism of abnormal glucose metabolism with non-alcoholic fatty liver disease ( NAFLD) .Methods Sixty SD rats were ran-domly divided into impaired glucose tolerance (IGT) model group (n=20), type 2 diabetes mellitus (T2DM) model group (n=20), IGT control group (n=10) and T2DM control group (n=10).IGT models were produced by feeding high-fat diet, T2DM models were produced by feeding high-fat diet for 4 weeks and intraperitoneally injected streptozotocin. Liver cell apoptosis was detected by TUNEL staining.The expression of MIF mRNA in liver tissue was determined by real-time PCR.The expressions of MIF, caspase-3, JNK proteins and phosphorylated JNK(p-JNK)in the liver tissue were de-termined by Western blotting.Results Apoptotic cells were obviously increased in the IGT and T2DM groups.Expression of MIF mRNA in the IGT and T2DM groups was markedly higher than that in the control group, respectively (P<0.01). The expressions of MIF, caspase-3, JNK proteins and phosphorylated JNK were markedly higher than that of the control group, respectively (P<0.05 or P<0.01).The expressions of MIF, caspase-3, JNK proteins in the T2DM group were significantly decreased compared with those of the IGT group, while the expression of phosphorylated JNK was significantly higher ( P<0.01) .Conclusions Abnormal glucose metabolism accompanied with NAFLD is probably related to the in-crease of MIF, Caspase-3, JNK and phosphorylated JNK expression.

[ ABSTRACT] AIM:To observe the changes of perilipin and adipose differentiation-related protein ( ADRP) du-ring the development of diabetes mellitus and to explore the effect of perilipin and ADRP on abnormal glucose metabolism with non-alcoholic fatty liver disease ( NAFLD) .METHODS:The rat model of impaired glucose tolerance ( IGT) was in-duced by feeding high-fat diet, and the type 2 diabetes mellitus (T2DM) model was induced by feeding high-fat diet for 4 weeks and intraperitoneally injecting streptozotocin.The morphological change of the liver tissue was observed under optical microscope.The serum contents of perilipin and ADRP were measured by ELISA.The mRNA expression of perilipin and ADRP in the liver tissues was detected by real-time PCR.The protein expression of ADRP in the liver tissues was deter-mined by Western blotting.RESULTS:HE staining showed steatosis in the liver of the rats in IGT group was more serious than that in T2DM group.The biochemical and the pathological processes of rat models were consistent with the clinical feature of related diseases.The serum content of perilipin had no difference among various groups.The mRNA expression of perilipin in IGT group and T2DM group was significantly higher than that in control group.Compared with IGT group, the mRNA expression of perilipin in T2DM group was significantly increased.The serum content of ADRP in T2DM group was significantly lower than that in control group.The mRNA and protein expression of ADRP in model groups was signifi-cantly lower than that in control group.Compared with IGT group, the mRNA expression of ADRP in T2DM group was sig-nificantly reduced.CONCLUSION: The serum content of ADRP plays a role in the development and progression of T2DM.It is negatively correlated with HOMA-IR.NAFLD occurs during progression of abnormal glucose metabolism in-duced by feeding high-fat diet.The development of abnormal glucose metabolism with NAFLD is probably related to the in-creased expression of perilipin and the reduced expression of ADRP.

Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups: group A (alprostadil),group B(Oza-grel),group C(Dan red injection),group D(Xuesaitong),the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio(C/E) were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio(△C/△E) were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme.