Objective: To investigate the preliminary screening results of Alzheimer's disease (AD) among the elderly in Ningbo City, Zhejiang Province and analyze the influencing factors, so as to provide insights into prevention and control of AD in the elderly. Methods: A multi-stage stratified proportional sampling method was used to select the registered residents aged 60 years and older in Ningbo City as subjects. Demographic characteristics, lifestyle factors, physical conditions and social activities of the subjects was evaluated with questionnaires. AD was screened using the Mini-Mental State Examination (MMSE), and factors affecting the positive rate of AD preliminary screening were identified using a multivariable logistic regression model. Results: A total of 34 027 elderly residents were investigated, with an mean age of (71.71±6.89) years. There were 15 115 males (44.42%) and 18 912 females (55.58%), 16 146 residents living in rural areas (47.45%) and 17 881 residents living in urban areas (52.55%). The positive rate of AD preliminary screening was 7.28% (2 476 cases). Multivariable logistic regression analysis showed that age (70 to 74 years, OR=1.357; 75 to 79 years, OR=1.807; 80 to 84 years, OR=2.782; 85 years and older, OR=4.907), gender (female, OR=1.118), residence (urban areas, OR=0.713), marital status (unmarried, OR=3.078; widowed/separated/divorced, OR=1.301), educational level (primary school, OR=0.629; junior high school and above, OR=0.609), occupation before retirement (others, OR=0.741), family genetic history (no, OR=0.651), household disposable monthly income (1 000 to 1 999 Yuan, OR=0.636; 2 000 to 2 999 Yuan, OR=0.569; 3 000 Yuan and above, OR=0.448), exercise (seldom, OR=0.855; regular, OR=0.780), number of chronic diseases (2~5, OR=1.328), hearing loss (no, OR=0.764), smell loss (no, OR=0.615), chronic constipation (no, OR=0.696), major negative life events (no, OR=0.804), subjective memory loss (no, OR=0.583), sleep quality (general, OR=0.640; good, OR=0.616), living style (living with spouse, OR=0.300; living alone, OR=0.315; living with children, OR=0.350) and social activities (2-3 times/week, OR=0.584; 4 times/week and more, OR=0.409) were factors affecting the positive rate of AD preliminary screening. Conclusions The positive rate of AD preliminary screening among the elderly in Ningbo City is relatively high. Age, gender, economic conditions, exercise, social activities and physical conditions were factors affecting the positive rate of AD preliminary screening.

Objective:To evaluate the efficacy and safety profile of ixazomib/lenalidomide/dexamethasone (IRd) in Chinese patients with relapsed/refractory multiple myeloma (MM) .Methods:This study comprising 14 medical centers in China included patients with relapsed/refractory MM who received at least. Ixazomib at an initial oral dose of 4 mg was administered. Seven patients had dose adjustment to 3 mg at the time of first dose. The lenalidomide doses were adjusted according to creatinine clearance rate. The efficacy and safety were evaluated every cycle.Results:In the study cohort of 74 patients, the median age was 65 years and 11 (14.9% ) patients received over three lines of therapy. Overall response rate (ORR) was 54.1% (40/74) , and 7 (9.5% ) , 14 (18.9% ) , and 19 (25.7% ) patients achieved stringent complete response or complete response, very good partial response, and partial response, respectively. The median progression-free survival and overall survival were 9.9 and 20 months, respectively. The median time to response was 1 month. The efficacy and survival outcome were similar to those reported in the Tourmaline-MM1 China Continuous Study. The ORR of patients refractory to bortezomib, lenalidomide, and bortezomib plus lenalidomide were 52.0% (13/25) , 57.1% (4/7) , and 33.3% (6/18) , respectively. The rate of grade 3-4 adverse events was 36.5% (27/74) . Common hematological toxicities were anemia, thrombocytopenia, lymphopenia, and neutropenia. Common non-hematological toxicities were fatigue, gastrointestinal symptoms, and infections. Two cases of grade 3 peripheral neuropathy were reported. The patients eligible for the Tourmaline-MM1 China Continuous Study had a higher ORR than the ineligible patients [77.8% (14/18) vs 46.4% (26/56) , P=0.020]. There was no difference in the rate of grade 3-4 adverse events [33.3% (6/18) vs 37.5% (21/56) , P=0.749]. Conclusion:The IRd regimen had good efficacy and acceptable toxicity in Chinese patients with relapsed/refractory MM.

Purpose: 5-Fluorouracil (5-Fu) is used as a conventional chemotherapy drug in chemotherapy forpatients with advanced colorectal cancer, but many patients still suffer from treatment failuredue to 5-Fu resistance. Emerging observations revealed the important role of chemokine(C-X-C motif) ligand 13 (CXCL-13) in tumor microenvironment and its relationship with prognosisin patients with colorectal cancer. This study is designed to reveal the important roleof CXCL-13 in causing colorectal cancer resistance to 5-Fu. Materials and Methods: CXCL-13 levels of patient's serum or cell culture supernatants were measured separatelyby enzyme-linked immunosorbent assay. In cell assays, cell viability is detected by Cell CountingKit-8. Therefore, the recombinant human CXCL-13 was used to simulate its high expressionin cells while its antibody and siRNA were used to reduce CXCL-13 expression in cells. Results: In this study, we demonstrated that CXCL-13 is associated with 5-Fu resistance by culturemedium exchange experiments and cytokine arrays of colorectal cancer resistant and nonresistantcells. Clinical studies showed that CXCL-13 is highly expressed in the serum of5-Fu–resistant patients. High levels of serum CXCL-13 also predict a worse clinical outcome.The addition of recombinant CXCL-13 cytokine resulted in 5-Fu resistance, while its antibodyovercame 5-Fu resistance, and knockdown of CXCL-13 expression by siRNA also reduced5-Fu resistance, which can be saved by added recombination CXCL-13. Conclusion These results not only identify a CXCL-13 mediated 5-Fu resistance mechanism but alsoprovide a novel target for 5-Fu–resistant colorectal cancer in prevention and treatmentstrategies.

Objective To compare the function recovery of multiple injuries combined with floating knee joint injury and simple knee joint injury,and to analyze the risk factors.Methods A retrospective case control study was conducted to analyze the clinical data of 41 patients with multiple injuries combined with Blake and McBryde Ⅱ A floating knee injury admitted to Xijing Hospital of Air Force Medical University from June 2011 to June 2017.There were 26 males and 15 females,aged 18-76 years,with an average of 34.5 years.There were 25 patients with simple knee joint injury and and 16 patients with multi-joint combined injury involving knee joint and ipsilateral hip joint or ankle joint injury.Surgical fixation was performed in different parts by external fixation,intramedullary nail and plate screw fixation.According to the Kalstr(o)m and Olerud functional evaluation criteria,the excellent and good rate of postoperative functional recovery was compared between the two groups.The surgical fixation methods of the two groups were compared.Logistic regression analysis was performed on the influencing factors of functional recovery.Results The patients were followed up for 1-7 years,with an average of 3 years.The excellent and good rate of overall functional recovery in the two groups was 68％,and the rate was 84％ in simple knee injury group and 44％ in multi-joint combined injury group (P ＜ 0.01).There was no significant difference in the ratio of intramedullary nail and plate screw fixation between the two groups (P ＞ 0.05),while the proportion of the external fixation in the multi-joint combined injury group [31％ (5/16)] was significantly higher than that in the simple knee joint injury group [16％ (4/25)] (P ＜ 0.05).Logistic regression analysis showed that the rate of external fixation was an independent factor affecting the postoperative function (OR =0.15,P ＜ 0.01).Conclusions The postoperative function in multi-joint injury patients is poorer than in the single joint injury patients.The higher rate of using external fixation in multi-joint injury patients is a risk factor.For Blake and McBryde Ⅱ A floating knee injury combined with multi-joint injury,less external fixation should be used,so as to improve the postoperative function.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*

Objective To study the correlation between the clinical characteristics of HCC patients with different phenotype circulating tumor cells in the peripheral blood.Methods 77 patients with HCC and 21 patients with benign liver diseases treated at Zhujiang Hospital of Southern Medical University from April 2015 to December 2016 were retrospectively studied.The CanPatrolTM System was adoptedto detect epithelial-mesenchymal phenotype CTCs in the peripheral blood.This study aimed to clarify whether the epithelial-mesenchymal phenotype CTCs were specifically originated from the tumorand to investigate the correlation between CTCs and the clinical features of the patients.Results Using epithelial and mesenchymal markers,the CTCs were divided into three subtypes:epithelial,mesenchymal and mixed CTCs.No epithelial-mesenchymal phenotype CTCs were detected in patients with benign liver diseases.The positivity rates of epithelial,mixed and mesenchymal CTCs in the peripheral blood of 77 patients with HCC were 37.7％ (29/77),74.0％ (57/77) and 50.6％ (39/77),respectively.The positivity rates of epithelial-mesenchymal phenotype CTCs in patients with HCC were significantly higher than the group of patients with benign liver diseases (P ＜ 0.05).The positivity rates of epithelial CTCs were significantly correlated with AFP,number of tumor and portal vein tumor thrombus (P ＜ 0.05).The positivity rates of mixed CTCs were significantly correlated with portal vein tumor thrombus,tumor differentiation and BCLC stage (P ＜ 0.05).The positivity rates of mesenchymal CTCs were significantly correlated with tumor size,portal vein tumor thrombus,tumor differentiation and BCLC stage (P ＜ 0.05).Conclusions The positivity rates of epithelial,mixed and mesenchymal CTCs were closely related to different aspects of clinical characteristics of patients with HCC.These CTCs may serve as indicatorsto evaluatethe progress of HCC.

OBJECTIVE: To investigate the situation regarding the cleaning and sterilization of endonasal endoscopes in department of otolaryngology in Hunan Province, and to provide strategy for improving the level of sterilization and management of endonasal endoscopes.
 METHODS: A total of 100 medical institutions were investigated by spot assessment, check and sampling. Data was analyzed by multivariate analysis.
 RESULTS: The qualified rate of rules and regulations for endoscopy was 28.8% in the second-class hospitals and 45% in the top-class hospitals. The qualified rate of environment for endoscopy cleaning and sterilization was 36.3% in the second-class hospitals and 85% in the top-class hospitals. The main problems include lack of independent disinfection room, the space not large enough, and/or lack of ventilation system. The qualified rate of bacterial detection for post-sterilized endoscopes and biopsy forceps was 93.8% in the second-class hospitals and 95.0% in the top-class hospitals, and the main pathogenic bacteria was gram-positive cocci and gram-negative bacilli. The multivariate analysis showed that the influencial factors for endoscope cleaning and disinfection are as follows: staffs responsible for the cleaning and sterilization of otolaryngology endoscopes, the standard for cleaning and disinfection process, and the frequency of endoscope use.
 CONCLUSION The present situation of cleaning and sterilization for otolaryngology endoscopes is better in the top-class hospitals than that in the second-class hospitals. The sterilization and management of otolaryngology endoscopy are needed to be improved, and the staff training is needed, especially in the primary hospitals.
Disinfection ; statistics & numerical data ; Endoscopes ; Equipment Contamination ; statistics & numerical data ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hospitals ; Humans ; Otolaryngology

Adrenal Gland Diseases ; diagnosis ; Female ; Humans ; Middle Aged ; Retroperitoneal Space

OBJECTIVE: To analyze the risk factors for allergic rhinitis and provide the scientific basis for disease control and intervention through investigation of the elementary and middle school students with allergic rhinitis in Changsha. METHODS: From January to April 2012, we randomly enrolled the elementary and middle school students aged at 10-17 years old in Changsha. We explored the risk factors for allergic rhinitis by using stratified and cluster sampling survey, questionnaire investigation, physical examination, skin pricking needling experiment and statistical analysis. RESULTS: A total of 814 students were investigated in cluster sampling survey. The result of the incidence of allergic individual was 26.3% and the prevalence of allergic rhinitis was 17.2%. Analysis of Visual Analog Scale Questionnaire (VAS) showed that allergic rhinitis exerted significant effect on student's character, memory, sleep quality, etc. CONCLUSION The prevalence of allergic rhinitis in the elementary and middle school students aged in Changsha is 17%-20%. The incidence and development is related to environment, genetic and living habits, which affects people's character, memory and sleep quality significantly.
Adolescent ; Child ; China ; epidemiology ; Humans ; Incidence ; Prevalence ; Rhinitis, Allergic ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Objective To explore the clinical characteristics and pregnancy outcomes of twin pregnancies complicated with severe preeclampsia.Methods The pregnant outcomes of 131 twin pregnancies (twin group) and 572 singleton pregnancies (singleton group),all complicated with severe preeclampsia,were analyzed retrospectively.All patients were treated in the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University from June 2007 to June 2011.The patients' age,onset of disease,gestational weeks at delivery,mean duration of expectant treatment,blood pressure,laboratory parameters and incidence of pregnancy complications,including placental abruption,heart failure,pulmonary edema,postpartum hemorrhage,uteroplacental apoplexy,eclampsia,HELLP syndrome (hemolysis,elevated liver enzymes and low platelets syndrome),hypoproteinemia,retinopathy,intracranial hemorrhage and renal insufficiency,were compared between the two groups.Perinatal outcomes such as premature delivery,perinatal mortality,neonatal intensive care unit (NICU) hospitalization,fetal distress,hypoxic-ischemic encephalopathy (HIE),asphyxia neonatorum,neonatal pneumonia,hyperbilirubinemia and neonatal hypoglycemia of two groups were also compared.Chi-square test,Fisher's exact test or t-test were used for statistical analysis.Results The severe preeclampsia incidence of twin pregnancies (5.03％,131/2604) was higher than that (1.94％,572/29 452) of singleton pregnancy (x2=106.40,P＜0.001).The onset time [(33.6±1.8) weeks] and gestations at delivery [(34.6±2.9) weeks] in twin group were earlier than those in singleton group [(34.4± 2.0) weeks,t=2.364,P＜0.05; (35.6±3.2) weeks,t=3.902,P＜0.05].The duration of expectant treatment of twin group [(6.4±0.3) d] were shorter than that of singleton group [(7.4± 0.5) d,t=5.314,P＜0.01].The incidence of placental abruption [9.9％ (13/131) vs 4.2％ (24/572),x2=7.013,P＜0.01],heart failure [11.5％ (15/131) vs 3.2％ (18/572),x2=16.430,P＜0.01],pulmonary edema [4.6％ (6/131) vs 0.9％ (5/572),x2=9.505,P＜0.01],postpartum hemorrhage [16.0％ (21/131) vs 7.0％ (40/572),x2 =10.990,P ＜ 0.01] and uteroplacental apoplexy [5.3％ (7/131) vs 0.5％ (3/572),x2 =17.650,P＜0.01] of twin group were higher than those of singleton group,respectively.The incidence of premature delivery [77.1％ (202/262) vs 29.9％ (171/572),x2=162.000,P＜0.05],NICU hospitalization [76.2％ (205/262) vs 58.4％(332/572),x2 =31.980,P＜0.05] and HIE [8.4％ (22/262) vs 4.7％ (27/572),x2 =4.392,P＜0.05] of twin group were higher than those of singleton group,respectively.Conclusions Twin pregnancy women are more likely to be complicated with severe preeclampsia and more vulnerable to suffer from severe complications,resulting in poor perinatal outcomes.More attentions should be paid on the management of twin pregnancy.Once hypertensive disorders complicating pregnancy is diagnosed,active management should be provided and timing of termination should be considered.