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Objective:To analyze the relationship between gait speed or grip strength and all-cause mortality in elderly inpatients over 75 years old, and to compare their predictive value for all-cause mortality.Methods:A prospective cohort study was conducted and enrolled elderly patients aged ≥75 years hospitalized from December 2016 to December 2019 at the Department of Integrated Medicine and Geriatrics, Fuxing Hospital, Capital Medical University.Gait speed(m/s)and grip strength(kg)were respectively measured via the 6-meter walk test and a dynamometer.The patients were followed up for more than 1 year after discharge, and the time of all-cause mortality was recorded.The Cox regression model was used to analyze the correlation between gait speed, grip strength or their combination and the risk of all-cause mortality.ROC curves were statistically analyzed using the DeLong test.Results:A total of 704 patients were enrolled, with an average age of(83.8±6.3)years; the median follow-up time was 33(24, 42)months.During the follow-up period, all-cause death occurred in 131 cases(18.6%).Compared with the high gait speed and high grip strength groups, the low gait speed and low grip strength groups had higher all-cause mortality(all P<0.05).The Cox regression model was used to analyze the relationships between gait speed, grip strength and all-cause mortality.The results showed that gait speed( HR=2.255, 95% CI: 1.462-3.477, P<0.001)and grip strength( HR=1.815, 95% CI: 1.232-2.673, P<0.001)were associated with the risk of all-cause mortality after adjustment for other factors; When gait speed slowed down and grip strength decreased, the risk of death reached the highest level( HR=3.156, 95% CI: 1.829-5.445, P<0.001).The AUC of the gait speed model(0.703, 95% CI: 0.667-0.736)was higher than the AUC of the grip strength model(0.648, 95% CI: 0.611-0.683), with a difference of 0.055(95% CI: 0.006-0.103, P=0.026). Conclusions:Decreased gait speed or grip strength is related to an increase of death risk.The risk of death is highest when the patient has both slowed gait speed and decreased grip strength.The predictive value of gait speed for death is better than grip strength.Together they can be used as simple, rapid and effective tools to predict all-cause mortality in this population.
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Objective:To investigate the clinical features and prognosis of patients with pancreatic metastasis from clear cell renal cell carcinoma(CCRCC).Methods:From Jan 2000 to May 2020, the clinical data of patients pathologically diagnosed as CCRCC with pancreatic metastasis and admitted in Cancer Institute and Hospital of Tianjin Medical University were analyzed retrospectively. The gender, age, metastasis time, relapse time, metastatic sites, numbers of metastatic lesions and whether metastatic pancreatic lesions should be surgerically removed were recorded and the influencing factors were analyzed.Results:Among the 20 patients, there were 12 males and 8 females. The median age of diagnosis was 50 years. There were 12 patients(60%) of left renal carcinoma and 8 patients(40%)of the other side. 12 cases(60%) had single pancreatic metastatic lesion and the other 8 cases(40%) had multiple metastatic lesions. Seven patients(35%) had other organs metastasis besides pancreatic metastasis. Two patients(10%) had simultaneous pancreatic metastasis and renal cancer, and the other eighteen patients(90%) had pancreatic metachronous metastasis after being diagnosed as renal cancer. The median time from the diagnosis of CCRCC to pancreatic metastasis was 102 months. Thirteen patients(65%)had recurrences within 10 years and the other seven patients(35%)had recurrences after 10 years. Pancreatectomy was performed in nine patients(45%) and targeted therapy was conducted in thirteen patients. The mean follow-up was 122.9 months (1-256 months). Three patients (15%) died and 17 patients (85%) survived. The median overall survival was 75.9 months, and the 5 year-survival rate was 66.7%. Simultaneous metastasis and extra-pancreatic metastasis were prognostic factors in patients with CCRCC with pancreatic metastasis.Conclusions:Pancreatic metastases from renal clear cell carcinoma were rare, but the prognosis was good, especially in patients with only pancreatic metastases several years after renal carcinoma was diagnosed.
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Objective@#To investigate the predictability on adverse events(re-hospitalization and death)in elderly discharged inpatients among frailty phenotype(FP), frail scale(FS)and clinical frailty scale(CFS), in order to screen the simple and feasible frailty assessment tools for elderly discharged inpatients.@*Methods@#Elderly discharged inpatients aged 65 years and over were recruited for this prospective cohort study.And they underwent frailty assessment by using FP, FS and CFS, respectively.Patients were followed up for more than 6 months after discharge, and adverse events including re-hospitalization or death after discharge were recorded.Cox regression model was adopted to evaluate the relationship between frailty and death or re-hospitalization.Predictive effects of three assessment methods on adverse events were compared by using receiver operating characteristic(ROC).@*Results@#A total of 527 elderly patients aged(84.1±6.0)years with males of 61.9%(326/527)were successfully followed up.The detection rate of frailty by FP and FS evaluation tools was 26.0%(137/527)and 26.0%(137/527), respectively.The detection rate of moderate and severe frailty by CFS was 25.2%(133/527). The Cox regression model showed that the mortality was significantly higher in frailty patients by FP, FS, and CFS than in the non-frailty patients(HR=3.72, 2.95 and 3.90, P=0.017, 0.016 and 0.002)after adjusting for age, smoking, co-morbidity and other variable; and that the re-hospitalization rate was significant higher in frailty patients by FP and CFS than in the non-frailty patients(HR=1.81 and 1.69, P=0.000 and 0.002). The areas under the receiver operating characteristic curve(AUC)of FP, FS and CFS for predicting death and re-hospitalization were 0.691, 0.645, 0.728 on death, and 0.570, 0.579, 0.602 on re-hospitalization(all P<0.01), respectively.@*Conclusions@#All three assessment tools of FP, FS and CFS have predictive effects on death in elderly inpatients with frailty, and CFS has better predictive effect than the other two tools.But FP, FS and CFS have poor predictive effect on re-hospitalization.
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Objective To investigate the predictability on adverse events(re-hospitalization and death)in elderly discharged inpatients among frailty phenotype(FP),frail scale(FS)and clinical frailty scale(CFS),in order to screen the simple and feasible frailty assessment tools for elderly discharged inpatients.Methods Elderly discharged inpatients aged 65 years and over were recruited for this prospective cohort study.And they underwent frailty assessment by using FP,FS and CFS,respectively.Patients were followed up for more than 6 months after discharge,and adverse events including re-hospitalization or death after discharge were recorded.Cox regression model was adopted to evaluate the relationship between frailty and death or re-hospitalization.Predictive effects of three assessment methods on adverse events were compared by using receiver operating characteristic (ROC).Results A total of 527 elderly patients aged(84.1±6.0)years with males of 61.9％ (326/527)were successfully followed up.The detection rate of frailty by FP and FS evaluation tools was 26.0％ (137/527)and 26.0 ％ (137/527).respectively.The detection rate of moderate and severe frailty by CFS was 25.2％(133/527).The Cox regression model showed that the mortality was significantly higher in frailty patients by FP,FS,and CFS than in the non-frailty patients(HR =3.72,2.95 and 3.90,P=0.017,0.016 and 0.002)after adjusting for age,smoking,co-morbidity and other variable;and that the re-hospitalization rate was significant higher in frailty patients by FP and CFS than in the non-frailty patients (HR =1.81 and 1.69,P =0.000 and 0.002).The areas under the receiver operating characteristic curve(AUC)of FP,FS and CFS for predicting death and re-hospitalization were 0.691,0.645,0.728 on death,and 0.570,0.579,0.602 on re-hospitalization (all P ＜ 0.01),respectively.Conclusions All three assessment tools of FP,FS and CFS have predictive effects on death in elderly inpatients with frailty,and CFS has better predictive effect than the other two tools.But FP,FS and CFS have poor predictive effect on re-hospitalization.
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Objective@#To analyze the influencing factors and mechanism for unprotected sexual behavior of men who have sex with men (MSM) in China.@*Methods@#MSM who are more than 16 years old and have had homosexual sexual behaviors in recent years were recruited from five cities (Tianjin, Harbin, Nanjing, Chongqing and Xi'an) with active MSM population during 2013-2014 through network, site recruitment and peer recommendation using convenient sampling method. 3 519 subjects were included in this study. The sexual behavior related information of MSM in five cities was investigated using questionnaires. The confirmatory factor analysis was used to construct the measurement model by using the robust estimation method based on the weighted least square method to estimate parameters, and the final model was determined through evaluation and modification.@*Results@#A total of 3 519 subjects were (29.9±8.76) years old, with a clear sexual orientation of 3 223 (91.6%), and 2 287 (65.0%) were aware of free HIV/AIDS treatment policies. The proportion of using condom last time was 77.2% (n=2 718), and the proportion of using condom every time was 36.9% (n=1 299) and 43.2% (n=1 521) respectively for the past six months with fixed and temporary partners. Structural equation model provided a good fit, the root mean square error of approximation, comparative fit index and non-normed fit index was 0.07, 0.97, 0.95, respectively. Knowing AIDS knowledge, educational level and sexual orientation had direct effects on unprotected sexual behavior, and the path coefficients were 0.179,-0.049 and -0.159, respectively. While the role of interventions was indirect, the path coefficient was 0.147.@*Conclusion@#Lower education and unclear sexual orientation are disadvantages for reducing unprotected sexual behavior. Interventions mainly affect the unprotected sexual behavior by improving the level of HIV/AIDS knowledge. Increasing the comprehensive knowledge of MSM through intervention should be highly valued.
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Objective To isolate Toxoplasma gondii T. gondii strains from stray cats and explore their prevalence in Xu?zhou City. Methods The sera of 41 stray cats were collected to detect the antibodies of T. gondii by using a commercial enzyme?linked immunosorbent ELISA kit. The tissues including the heart brain and tongue from these cats were digested by acid pep?sin solution and inoculated to Kunming mice. These suspicious isolates were subsequently identified by a specific PCR method. Results A total of 11 strains were isolated from 41 stray cats which were confirmed by the PCR results. Moreover 17 cats 41.5% were found to be positive with the antibodies of T. gondii. Conclusion A high prevalence of T. gondii infection was found in Xuzhou City which indicates that the stray cats infected with T. gondii would be an important infection source that may infect humans and other animals in this area.
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Objective To explore the inhibitory effect of astragalus polysaccharide (APS) on the proliferation of human erythroleukemia K562 cells and its mechanisms.Methods After K562 cells (purchased from Shanghai cell bank of chinese academy of science) were treated with different concentrations (0 mg/L,100 mg/L,200 mg/L and 400 mg/L) of APS.The influences of APS on the growth rate,doubling time and cell cycle distribution of K562 cells were observed by methyl thiazolyl tetra-zolium assay (MTF) and flow cytometry,respectively.Furthermore,the reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting assay were used to detect the expressions of Cyclin A,Cyclin B,Cyclin E and p21 gene at the mRNA and protein levels,respectively.Results MTT assay findings showed that,compared to the control group (0 mg/L APS),growth rates of K562 cells treated with 100 mg/L,200 mg/L and 400 mg/L APS decreased significantly (all P ＜ 0.01),and the doubling times lengthened significantly (all P ＜ 0.01).Flow cytometry findings revealed that,compared to the control group,the G1 phase cells in K562 cells of APS group increased significantly (P ＜0.01),while the S and G2/M phase cells decreased significantly (all P ＜ 0.01).RT-PCR and Western blotting results indicated that Cyclin B and Cyclin E expression of K562 cells at the mRNA and protein levels in the APS group were significantly lower than those of the control group(all P ＜ 0.01),whereas p21 expression was significantly enhanced at mRNA and protein levels (P ＜ 0.01),and Cyclin A expression was not significantly different at mRNA and protein levels between the 2 groups (all P ＞ 0.05).Conclusions APS could inhibit the proliferation of human erythroleukemia K562 cells.APS could inhibit the proliferation of K562 cells by down-regulating the expression of Cyclin B and Cyclin E and up-regulating the expression of p21.
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A fast, specific, sensitive, convenient, and economical rapid-dot-immunogold staining (R-Dot-IGS) assay was used to detect serum antibodies in patients infected with Schistosoma japonicum. The soluble egg antigen of Schistosoma japonicum was added onto microspore membrane. After pre-reacting and blocking, the serum to be detected and sheep anti-human IgG labeled with chloroauric acid were added sequentially. The assay took 15 minutes. For comparison, the dot-immunogold silver staining (Dot-IGSS) and rapid micro-volume Dot-IGSS (RM-Dot-IGSS) assay were also performed. The positive rate to detect the serum of schistosomiasis japonica by the R-Dot-IGS, Dot-IGSS and RM-Dot-IGSS assay was 98%, 98% and 100%, respectively. Samples from 50 healthy controls, 10 cases of clonorchiasis, and 10 cases of paragonimiasis showed negative reactions except for one case of clonorchiasis with RM-Dot-IGSS assay. Compared with Dot-IGSS and RM-Dot-IGSS, R-Dot-IGS assay has similar sensitivity and specificity, but the latter is quicker, simpler, and cheaper. Therefore, R-Dot-IGS is strongly recommended for rapid diagnosis of schistosomiasis japonica both in epidemiological study and in the clinic.