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Objective: To evaluate correlation between contrast-enhanced ultrasonography Liver Imaging Reporting and Data System (CEUS LI-RADS; v. 2017) categories (LR 3–5 vs LR-M) and outcomes in patients with early-stage hepatocellular carcinoma (HCC) after initial therapy. Methods: In this retrospective study, 272 patients with high risks for HCC and solitary clinically or pathologically confirmed HCC were identified between January 2010 and December 2015. Patients were initially treated by resection and radiofrequency ablation (RFA) according to the Barcelona Clinic Liver Cancer staging system and were followed up until December 31, 2018. Recurrence-free survival (RFS) and overall survival (OS) were compared between nodules assigned as LR 3–5 or LR M according to CEUS LI-RADS v. 2017 by using the Kaplan-Meier curve, log-rank test, and Cox proportional hazard model. Results: Early washout is the key determinating whether a nodule is classed as LR-M. Treatment procedures and LI-RADS category showed an independent correlation with OS and RFS (p < 0.05). LR 3–5 category were more correlated with better OS (88.6 months and 74.2 months, respectively; p = 0.017) compared with LR-M. Surgical resection demonstrated longer OS and RFS than RFA in LR-M patients and longer OS in LR 3–5 patients (p < 0.05). Besides, there was no significantly difference in OS and RFS between two categories in resection (p > 0.05), while for patients treated with RFA, LR 3–5 patients showed significant longer OS and RFS than LR-M patients (p < 0.05). Conclusion: Patients with HCC assigned as LR-M showed worse RFS and OS and surgical resection tended to be a more effective treatment for these patients. Advances in knowledge: Putting forward a theory that CEUS LI-RADS categories could independently predict the outcome for patients with solitary HCC at early-stage after initial treatment.

ObjectivesTo analyze the serum lipid profiles and investigate the relationship between the lipoprotein cholesterol levels and all-cause mortality in Chinese inpatient centenarians.DesignRetrospective study.MethodsCentenarians aged 100 years and older were admitted from January 2010 to January 2021 in our hospital. All centenarians completed a follow up visit till April 2021 of all-cause mortality and serum lipid profiles, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels. Cox proportional hazard models were used to assess the association between lipid profiles and all-cause mortality.Results(1) These 121 centenarians on average were 100.85 ± 1.37 years old (100~107 years), including 114 males and 7 females. (2) The rate of treatment with lipid-lowering drugs was 69.4%, and the lipid-lowering drugs were mainly statins (63.6%). (3) The results of serum lipid profiles were as follows: TC 3.90 ± 0.69 mmol/L, TG 1.36 ± 0.55 mmol/L, HDL-C 1.14 ± 0.24 mmol/L, and LDL-C 2.05 ± 0.46 mmol/L. (4) The median follow-up time was 589 days (95% CI: 475, 703), and the all-cause mortality rate was 66.1%. (5) Multivariable analysis showed that higher TC level (HR = 1.968, 95% CI = 1.191–3.253, P = 0.008), lower LDL-C level (HR = 0.379, 95% CI = 0.212–0.677, P = 0.001) was independent factors contributed to all-cause mortality. Sensitivity analysis showed that the above results were stable. The therapy and complication morbidity did not present significant publication bias.ConclusionsThe serum lipid profiles of Chinese inpatient centenarians were lower than those of the previous studies. Low LDL-C level was associated with an increased risk of all-cause mortality, which may indicate that more intensive lowering of LDL-C had a potential adverse effect on all-cause mortality for centenarians.

Objective Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is an accurate method to document changes in blood pressure (BP) and is more predictive than office and home BP monitoring for cardiovascular outcomes in elderly people. We aimed to determine the relationship between ABPM indices and renal damage in elderly Chinese male patients with essential hypertension. Methods We investigated 998 Chinese men (mean age of 78.44 ± 12.02 years) with essential hypertension. Renal function, laboratory testing, and ABPM, including ABP, BP variability, and BP circadian rhythms were investigated. Data were shown according to BP controlling status. The relationships between ABPM indices and renal damage [expressed by urine protein, urine albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN)] were assessed using multiple regression analysis. Results After adjustments for age, common cardiovascular risk factors, and medications, uACR level was positively associated with 24-h mean systolic blood pressure (SBP), 24-h mean pulse pressure (PP), and 24-h SBP percent time of elevation. eGFR level was negatively associated with the 24-h mean SBP and 24-h mean PP. BUN level was positively correlated with the 24-h mean SBP, 24-h mean PP, and 24-h SBP percent time of elevation, whereas the BUN level was negatively associated with the 24-h DBP SD. Conclusion The ABPM indices associated with renal damage may be regarded as an early predictive marker for renal function impairment in Chinese elderly male patients with hypertension.

Purpose Our purpose was to report a case of adult pancreatoblastoma, and review the literature in order to assist clinicians in the management of the disease. Materials and methods The demographic, clinical, and imaging findings of 41 patients with pathologically proven pancreatoblastoma from 1986 to 2017 identified in PubMed were reviewed. The key words used for searching PubMed were: “pancreatoblastoma”, “pancreatic tumor”, and “adult pancreatoblastoma.” We also reported the details of a case of adult pancreatoblastoma treated at our institution. Results We identified 41 cases of adult pancreatoblastomas, and the mean age at diagnosis was 41.4 ± 17.4 years. Pancreatoblastomas occurred in the pancreatic head in 48.4% of patients, and in 39.0% of cases the tumor was >8 cm in diameter at diagnosis. Patient age and tumor size were similar between males and females (P = 0.59; P = 0.32, respectively). Metastases was present in 17 of the 41 adult patients (41.5%). No significant difference in age, sex, tumor size, and tumor location was found between patients with and without metastases (P = 0.57, 0.58, 0.64, 0.39, respectively). Conclusion Preoperative diagnosis of adult pancreatoblastoma is difficult because of the heterogeneous, variable cellular differentiation and atypical clinical and imaging features. A pancreatoblastoma should be considered when tumors in the pancreas are solid and cystic.

Background Reserpine is currently used by millions of Chinese hypertensive patients, in spite of the continued concern of its depressogenic effect, even when used in low dose. This study aimed to investigate the association between low-dose reserpine use and depression in older Chinese hypertensive patient. Methods In this cross-sectional, case-control study, we recruited patient aged 60 years or over who had regularly taken one or two tables of “compound reserpine and triamterene tablets (CRTTs)” for more than one year (reserpine user) from 26 community health centers located in 10 provinces in China. For each patient who took CRTTs, we selected an age (within five years) and sex matched hypertensive patient who had never taken any drugs containing reserpine (non-reserpine user) as control. Depressive symptoms were evaluated using a Chinese depression scale adapted from the Zung Self-Rating Depression Scale. Demographic, clinical data and laboratory examination results within six months were collected. Results From August 2018 to December 2018, 787 reserpine user and 787 non-reserpine user were recruited. The mean age of all study subjects was 70.3 years, with about equal numbers of males and females. The mean depression score was 40.4 in reserpine users and 40.6 in non-reserpine users (P = 0.7). The majority of study subject had a depression score < 53 (87.6% in reserpine users and 88.2% in non-reserpine users, respectively). There were no significant differences in the prevalence of mild, moderate or severe depression in reserpine users and non-reserpine users. Conclusions There is no association between low-dose reserpine use and depression in older hypertensive patient. The role of reserpine in the treatment and control of hypertension should be reconsidered; and further studies, especially randomized, controlled clinical trials to compare efficacy and safety of reserpine and other widely recommended anti-hypertensive agents are needed.

To investigate the mechanism of Paris forrestii (Takht.) H. Li (PCT3)-suppressing the proliferation of HL-60, K562, KG-1 and HT-93 cells.cute myeloid leukemia cell lines such as HL-60, K562, KG-1 and HT-93 were treated with Paris forrestii (Takht.) H. Li (PCT3) for 24, 48, and 72 h, and MTT assay was employed to determine the cells proliferation. Meanwhile, the apoptosis of K562, HL-60, KG-1 and HT-93 cells were detected by flow cytometry after PCT3 (Control, 4 μg/ml, 8 μg/ml) treated for 24 h and the Western blot was performed to detect the expression of PARP,Caspase-3, MCL-1, BAX, BCL-2, P53, and P27. GAPDH was used as an internal loading control.MTT assay showed that Paris forrestii (Takht.) H. Li (PCT3) significantly inhibited the proliferation of HL-60, K562, KG-1 and HT-93 cells in concentration and time-dependent manners. Compared with the control group, the leukemia cell viabilities were significantly suppressed (r =0.9436; r =0.8623; r =0.9922; r =0.8918). Paris forrestii (Takht.) H. Li (PCT3) induced apoptosis of leukemia cells in a concentration dependent manner, compared with the control group (P＜0.05 or P＜0.01). Western blot revealed that PARP, a major enzyme in DNA damage repair, and Caspase-3 another one of the major executive apoptotic enzymes were cleaved in cell lines examined, and this cleavage was concentration dependent. Anti-apoptotic proteins such as MCL-1 and BCL-2 were down regulated by Paris forrestii (Takht.) H. Li (PCT3), and Pro-apoptotic protein BAX was upregulated. And the protein of tumor suppressor gene P53 and its downstream signaling protein P27 increased.Paris forrestii (Takht.) H. Li (PCT3) can inhibit the proliferation of leukemia cells by activating endogenous apoptosis pathway, and provide a potential new drug selection for clinical treatment of AML leukemia.

Molybdenum trioxide (MoO3) microrods, nanofibers, and nanoplates were synthesized via the hydrothermal method and high-temperature calcination method, respectively. Then the MoO3 was added into polyurethane elastomer, respectively. The flame retardancy and smoke suppression of the composites added with different MoO3 were studied by thermal gravimetric analysis, cone calorimeter, and smoke density. The results show that the three kinds of MoO3 with different morphologies could promote the formation of char and possess flame retardancy and smoke suppression, and MoO3 nanofibers exhibit a higher degree of flame retardancy, and 1 wt% addition could make the peak heat release rate of polyurethane elastomer composites reduce from 881.6 kW m−2 for a pure sample to 343.4 kW m−2, a decrease by 61.0%. As for smoke suppression, MoO3 nanoplates possess the best smoke suppression; 5 wt% could decrease a pure sample's smoke density by 41.3% from 361 to 212. Moreover, the char residue of composites after combustion was analyzed by Raman spectra and X-ray photoelectron spectroscopy, and the flame retardancy and smoke suppression mechanisms of MoO3 were discussed.

Treatment and prognosis of Fanconi anaemia (FA) and acquired aplastic anaemia (AA) differ. However, delayed and inappropriate treatments are administered in FA due to its similarities to AA in presentation. The objective of the current study was to elucidate differences between the molecular mechanisms underlying FA and AA as well as to identify biomarkers and pathways associated with FA via bioinformatics analyses. Proteomic data were obtained from bone marrow samples of patients with FA and AA. Gene ontology analysis was performed using a Database for Annotation, Visualization and Integrated Discovery. KEGG pathway enrichment analyses were conducted using the ClueGO plug-in in Cytoscape. A DEP-associated protein-protein interaction (PPI) network was constructed using STRING and visualized in Cytoscape. A total of 114 DEPs, including 71 upregulated proteins and 43 downregulated proteins, were present in the FA samples, compared with those in the AA samples. Upregulated proteins were enriched in the nucleosome assembly, canonical glycolysis, glycolytic process, and the glycolysis/gluconeogenesis pathway, whereas downregulated proteins were enriched in relation to immune response, negative regulation of apoptosis, proteolysis and CoA biosynthesis. Eight hub proteins with a high degree of connectivity were obtained as follows: alpha-enolase (ENO1), HSP90AA1, phosphoglycerate kinase 1 (PGK1), HSP90AB1, ACTC1, ACTBL2, EEF1A1 and CFL1. Upregulation of ENO1 and CFL1 in patients with FA was confirmed through a WB experiment, and substantiated by the results of data analyses. Bioinformatics analyses are useful for identification of biomarkers and pathways associated with FA and AA. Some crucial DEPs, such as ENO1, PGK1, ACTC1, ACTBL2, EEF1A1 and CFL1, may play an important role in FA and show potential as serological markers for its early diagnosis.

The application of industrial robot technology to ultrasonic non-destructive testing technology can meet the requirements of high efficiency and high precision in the nondestructive testing process. The trajectory planning method and the calculation method of the motion point in robotic manipulator motion control technology are of great significance in automatic NDT. In this paper, the Staubli manipulator product is taken as the object. For the two cases in which the manipulator grips the workpiece and the manipulator grips the ultrasonic transducer in the ultrasonic detection process, the calculation methods of the corresponding motion points are respectively proposed and the correctness of the method was verified by ultrasonic nondestructive testing.

Automated optical inspection (AOI) system is popularly used in the manufacturing industry. It can be used for accurate and precise inspection and measurement beyond human inspector. However, the development of an AOI system is unlike the general system. There are some specific steps or considerations simply only for the development of AOI system. In order to design the development process of AOI system systematically, a series of guidelines are proposed in this paper based on the practical experience. Many important issues are listed and discussed. Some practical examples are used to illustrate the importance of guidelines. The guidelines are also mapping to the traditional waterfall model for better understanding. They are expected to be helpful to increase the efficiency of AOI system development.

The defects located on the curved surface are difficult to be distinguished by the traditional reflected echo waves, in this paper, the transverse wave is applied to test those micro-cracks, which near to the test surface. A high recurrence positional accurate robotic manipulator is used for manipulating the test object so that the positional accuracy of robotic scanning trajectory can be guaranteed, as well as the incident angle and ultrasonic propagation length. Signal to noise ratio of ultrasonic A-scan waves is improved when the constraint parameters are correct, moreover, ultrasonic C-scan image is offered to the inspector to gain the nondestructive evaluation conclusion. Experimental results indicate the crack with minimize width of 0.15 mm that can be identified by the proposed robotic NDT system, when the oblique incident test method is used, the transverse waves can be excited so that the characteristic of defects can be displayed in the C-scan image.

In order to solve the problem of the large-scale complex surface composite testing, a multi-degree-of-freedoms flexible air-coupled ultrasonic testing system is designed by using the mature robot technology and air-coupled technology. Experimental results show that the system can not only meet the requirements of air-coupled detection, but also can use other non-destructive testing techniques such as water-coupled or water-jet-coupling ultrasonic inspection technology to form a variety of reflection and transmission detection systems, which greatly improves the efficiency of inspection and reduces the detection cost.

Although aspirin resistance is well reported in CVD, little is known about aspirin response in elderly patients with hyperhomocysteinaemia. The aim of the present study was to explore the prevalence of aspirin resistance in elderly patients with CVD and hyperhomocysteinaemia. A total of 370 elderly patients with CVD were recruited. The study included 216 patients with hyperhomocysteinaemia and 154 patients with normohomocysteinaemia receiving daily aspirin therapy (≥75 mg) over 1 month. The effect of aspirin was assessed using by light transmission aggregometry (LTA). Aspirin resistance was defined as ≥20% arachidonic acid induced aggregation according to LTA. Aspirin resistance was defined in 48 (13.0%) of 370 patients. The prevalence of aspirin resistance was higher in hyperhomocysteinaemic patients than normohomocysteinaemic patients (16.7% vs. 7.8%, odds ratio (OR) = 2.367; 95% confidence interval (CI) = 1.188–4.715, p = 0.012). In the multivariate logistic regression analysis, hyperhomocysteinaemia (OR = 2.406, 95% CI = 1.201–4.820, p = 0.013) was a significant risk factor for aspirin resistance. A significant number of CVD patients with hyperhomocysteinemia are resistant to aspirin therapy. Hyperhomocysteinemia is a significant risk factor for aspirin resistance in elderly patients with CVD.

Aim Sarcopenia and sarcopenic obesity are significant associative factors for functional impairment related to aging. The main aim of the present study was to investigate the prevalence of sarcopenia and sarcopenic obesity, and their associations with functional status among men aged 80 years and older in Beijing. Methods A total of 75 young healthy volunteers, and 101 older men aged 80 years and older participated in the present study. Demographic characteristics, anthropometry, skeletal muscle mass measured by dual X-ray absorptiometry (DXA), 6-m gait speed and handgrip strength were collected. Relative appendicular skeletal muscle index (RASM) and percentage skeletal muscle index (SMI) were obtained. Results Overall, the prevalence of sarcopenia was 45.7% by using RASM. By the weight-adjusted skeletal muscle index definition (SMI), the prevalence of sarcopenia was 53.2%. The prevalence of sarcopenic obesity was lower by using RASM than SMI (4.9% vs 11.5%, P 0.05, by RASM; 0.75 ± 0.25 vs 0.92 ± 0.27 vs 0.82 ± 0.35 m/s, P > 0.05 by SMI), respectively. Multiple linear regression analyses showed that thigh skeletal muscle mass was positively correlated with gait speed independently (β = 0.221, P = 0.011), and total body fat (β = −0.216, P = 0.002) and age (β = −0.524, P = 0.000) were negatively correlated with gait speed independently. Conclusions The prevalence of sarcopenia is high either based on RASM or SMI among Chinese men aged 80 years and older. Functional limitations were significantly associated with older age, skeletal muscle mass and total body fat. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 29–35.

The effect of anxiety emotion on information processing of decision making was explored by computer stimulate experiment. The results showed that people with high anxiety used longer time to processing information than that with low anxiety. The depth of information search of low anxiety was more than that of high anxiety. Individual with high anxiety was inclined to use heuristic strategies, and Individual with low anxiety was inclined to adopt analysis strategies.

Background Metabolic syndrome is known to be a prothrombotic state. We undertook this study to examine a hypothesis that aspirin resistance may be associated with metabolic syndrome, and to assess other potential determinants of aspirin resistance in patients with cardiovascular disease (CVD). Methods A total of 469 elderly patients with CVD were recruited. One hundred and seventy-two patients with metabolic syndrome and 297 without metabolic syndrome (control group) received daily aspirin therapy (≥ 75 mg) over one month. Platelet aggregation was measured by light transmission aggregometry (LTA). Aspirin resistance was defined as ≥ 20% arachidonic acid (AA)- and ≥ 70% adenosine diphosphate (ADP)-induced aggregation according to LTA. Aspirin semi-responders were defined as meeting one (but not both) of these criteria. Results By LTA, 38 of 469 (8.1%) patients were aspirin resistant. The prevalence of aspirin resistance was higher in the metabolic syndrome group compared with the control group [11.6 % vs. 6.6%, odds ratio (OR) = 2.039; 95% confidence interval (CI): 1.047–3.973]. In the multivariate logistic regression analysis, metabolic syndrome (OR = 4.951, 95% CI: 1.440–17.019, P = 0.011) was a significant risk factor for aspirin resistance. Conclusions A significant number of patients with CVD and metabolic syndrome are resistant to aspirin therapy. This might further increase the risk of cardiovascular morbidity and mortality in these patients.

We aim to retrospectively analyze the causes of death in elderly inpatients with hypertension in a hospital-based population in China. During the study period of over 15 years, a total of 2314 cases of death in 19,996 hospitalized hypertensive patients with the age of 60 years or older were documented. The three leading causes of death were disease of heart (45.2%), cerebrovascular disease (34.3%) and renal failure (11.9%), accounting for more than 90% of death from all causes. Gender, age, stage of hypertension and risk stratification is associated with the constituent ratios of the causes of death.

Aspirin resistance is recognized in different population. However, the prevalence and clinical events of aspirin resistance in elderly male patients with cardiovascular disease (CVD) have not been reported.We enrolled 304 elderly male patients with CVD receiving daily aspirin therapy (≥ 75 mg) more than 1 month. Platelet aggregation was measured by light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). The median follow-up time was 1.8 years. The primary outcome was the composite of death, myocardial infarction, unstable angina, stroke and transient ischemic attack.By LTA, 25 (8.2%) of elderly patients were aspirin resistant and 106 (34.9%) patients were semiresponders. According to TEG, 62 patients (20.4%) were found to be resistant to aspirin therapy. Of the 62 patients with aspirin resistance by TEG, 21 patients were aspirin resistant by LTA. Twenty-two of the 106 semiresponders by LTA were aspirin resistant by TEG. Patients with aspirin resistance or aspirin semiresponders were at increased risk of the composite outcome compared with aspirin-sensitive patients by LTA (18.3% vs 9.8%, Hazard ratio (HR) = 1.864, 95% confidence interval (CI): 1.046-3.324 p = 0.039). However, aspirin resistance was not associated with an increased risk of clinical vascular events compared to aspirin-sensitive patients by TEG (17.7% vs 10.9%, p = 0.452). In addition, Cox proportional hazard regression modeling demonstrated that aspirin resistance or semiresponders (HR = 3.050, 95% CI: 1.464-6.354, p = 0.003) and diabetes (HR = 2.055, 95% CI: 1.060-3.981, p = 0.033) were associated with major adverse long-term outcomes.Aspirin resistance or semiresponders, defined by LTA, are associated with an increased risk of adverse clinical events in elderly male patients with CVD.

Through analysis of the dynamics process of hydraulic rock drill, this paper builds a model of the impact mechanism of hydraulic rock drill with AMESim software, obtains curves of the displacements of the piston and valve core, and gets the pressure of the piston chamber. The dynamic analysis of the results indicates that the model of the impact mechanism of hydraulic rock drill agrees well with the principle of hydraulic rock drill. As a result, this research provides a new theoretical basis and method for the hydraulic rock drill.

Summary Background Aspirin resistance in patients with diabetes is recognized. However, the prevalence and related risk factors for aspirin resistance in elderly patients with Type 2 diabetes have not been reported, which is why we undertook this study. Methods One hundred and forty elderly patients (age, 73.84±8.02 years) with Type 2 diabetes receiving daily aspirin therapy (≥75mg) over 1 month were recruited. Platelet aggregation was measured by light transmission aggregometry (LTA) and thrombelastography (TEG) platelet mapping assay. The definitions of aspirin resistance were 20% or greater arachidonic acid-induced and 70% or greater adenosine diphosphate-induced aggregation by LTA. Aspirin semiresponders were defined as meeting one (but not both) of these criteria. Aspirin resistance by TEG was defined as 50% or greater aggregation induced by arachidonic acid. Results By LTA, 6 (4.3%) patients with Type 2 diabetes were found to be resistant to aspirin therapy; 44 (31.4%) patients were semiresponders. By TEG, 31 patients (22.1%) were aspirin resistant. Of the 31 patients who were aspirin-resistant by TEG, 3 were aspirin-resistant by LTA. Eight of 44 semiresponders by LTA were aspirin-resistant by TEG. In the multivariate logistic regression analysis, being female (odds ratio: 5.54, 95% confidence interval: 1.17–27.47, p =0.036) and homocysteine levels (odds ratio: 1.15, 95% confidence interval: 1.00–1.31, p =0.043) were significant risk factors for aspirin resistance by TEG. Conclusion The prevalence of aspirin resistance in elderly patients with Type 2 diabetes was considerably higher in female patients and in patients with higher serum levels of homocysteine.

The objective of this study was to investigate left cardiac damage and the cardioprotective effects of resveratrol in old rats with COPD. Rats 22 months old were divided into three groups: control (CTL), smoking and lipopolysaccharides (SM/LPS), and SM/LPS plus resveratrol (SM/LPS-Res). Cardiac function, pathology, oxidative stress, and apoptosis index were measured. Expression of myocardial SIRT1 was studied by real-time quantitative polymerase chain reaction (PCR) and Western blot detection. The heart weight – body weight ratio (LVW/BW) increased in the SM/LPS group compared with the CTL group. Both the LVW/BW and the area of fibrosis in the SM/LPS-Res group decreased compared with those in the SM/LPS group. 8-OHdG expression increased in cardiac tissue of rats in the SM/LPS group, which could be inhibited by resveratrol. Resveratrol significantly increased the activity of superoxide dismutase (SOD) and reduced the cardiac malonyldialdehyde (MDA) level in the SM/LPS-Res group. There was a significant decrease in the extent of cardiomyocyte apoptosis in the SM/LPS-Res group compared with the SM/LPS group. SIRT1 mRNA increased in the SM/LPS-Res group compared with the SM/LPS group. In conclusion, resveratrol attenuated cardiac oxidative damage and left ventricular remodeling and enhanced the decreased expression of SIRT1 in hearts of old rats with emphysema and thus might be a therapeutic modality for cardiac injury complicated in chronic obstructive pulmonary disease (COPD).

Sarcopenia and sarcopenic obesity are significant associative factors for functional impairment related to aging. The main aim of the present study was to investigate the prevalence of sarcopenia and sarcopenic obesity, and their associations with functional status among men aged 80 years and older in Beijing.A total of 75 young healthy volunteers, and 101 older men aged 80 years and older participated in the present study. Demographic characteristics, anthropometry, skeletal muscle mass measured by dual X-ray absorptiometry (DXA), 6-m gait speed and handgrip strength were collected. Relative appendicular skeletal muscle index (RASM) and percentage skeletal muscle index (SMI) were obtained.Overall, the prevalence of sarcopenia was 45.7% by using RASM. By the weight-adjusted skeletal muscle index definition (SMI), the prevalence of sarcopenia was 53.2%. The prevalence of sarcopenic obesity was lower by using RASM than SMI (4.9% vs 11.5%, P0.05). When we compared the sarcopenia prevalence (%) in obese participants, it was also remarkably lower by using RASM (40.0%) than SMI (95.0%). By using either RASM or SMI, gait speed was of no significant difference among the pure sarcopenia group, pure obese group and sarcopenic obesity group (0.76 ± 0.27 vs 0.82 ± 0.37 vs 0.82 ± 0.27 m/s, P0.05, by RASM; 0.75 ± 0.25 vs 0.92 ± 0.27 vs 0.82 ± 0.35 m/s, P0.05 by SMI), respectively. Multiple linear regression analyses showed that thigh skeletal muscle mass was positively correlated with gait speed independently (β = 0.221, P = 0.011), and total body fat (β = -0.216, P = 0.002) and age (β = -0.524, P = 0.000) were negatively correlated with gait speed independently.The prevalence of sarcopenia is high either based on RASM or SMI among Chinese men aged 80 years and older. Functional limitations were significantly associated with older age, skeletal muscle mass and total body fat.

To further investigate an effect of hemoglobin level on organs and functions of chronic obstructive pulmonary diseases (COPD) patients with anemia, in order to provide clinical data on intervention for COPD patients with anemia.We retrospectively analyzed the predictive value of hemoglobin (Hb) level on the survival of inpatients, collected from 4960 COPD cases of three level of first-class hospitals.(1) In 4960 COPD cases, there were 1009 cases with Hb110 g/L (males/females was 1009/4960, 20.34%); (2) The prevalence rate of pulmonary embolism (PE), congestive heart failure (CHF) and chronic renal failure (CRF) were significantly increased in the Hb level110 g/L andor = 110 g/L group (P0.05); (3) Age, smoking, respiratory failure (RF), ischemic heart disease (IHD), pulmonary heart disease (PHD), CHF, atrial fibrillation (AF), PE, ARF, CRF, PaCO2, PaO2, and Hb levels were significantly different between survival and death group (P0.01); (4) Using stepwise regression analysis, age, smoking, Hb level, PaO2, RF, CRF, ACF, PHD, CHF and IHD had significantly association with death (P0.05); (5) Hb levels was significantly associated with death (95% CI 1.2975-2.8512 , P = 0.0014 ).Low hemoglobin level (110 g/L) was significantly associated with death, and thus may be a valuable predictive marker for mortality of hospitalized COPD patients.

Twenty-four hour ambulatory blood pressure monitoring (ABPM) is an accurate method to document changes in blood pressure and is more predictive than office blood pressure (OBP) and home blood pressure (HBP) monitoring for cardiovascular outcomes in elderly people, but the relationship between ABPM

This study was aimed to detect the level of soluble interleukin-2 receptor (sCD25) and cytotoxic activity of NK lymphocytes in patients with hemophagocytic lymphohistiocytosis (HLH), and to explore their clinical significance in HLH. The enzyme-linked immunosorbent assay was used to detect the sCD25 level in serum of 20 patients with HLH, 15 healthy controls, 20 cases of acute myeloid leukemia and 20 cases of systemic lupus erythematosus. The NK cell cytotoxicity in peripheral blood of patients with HLH and controls were detected by flow cytometry with CD107a antibody labeling and LDH release assay. The results indicated that the level of sCD25 in HLH patients was significantly higher than that in healthy controls and disease groups (P0.001). The NK cell cytotoxicity in peripheral blood detected by both methods in patients with HLH were lower than that in healthy controls (P0.05), and the results detected by flow cytometry correlated significantly with those by LDH release assay (r = 0.73, P0.05). It is concluded that detection of sCD25 levels and NK cell activity in peripheral blood in HLH is of great value. Using flow cytometry following CD107a antibody labeling to measure NK activity is a simple, stability, reproducibility method and can be used for clinical diagnosis of HLH.

Hypertensive target organ damage (TOD) is the main reason for mortality or disability in elderly hypertensive patients. The studies on TOD of hypertension in Asia, especially in Chinese elderly hypertensive patients, are very limited. The aim of this study was to evaluate the prevalence and correlative factors of TOD in older Chinese hypertensive inpatients.This is a retrospective survey and data were collected from the computerized medical files of hypertensive inpatients from January of 1993 to December of 2008. The analysis was done on 17 682 inpatients, aged 60 years or older, with a diagnosis of essential hypertension (EH). The evidence of hypertensive TOD and associated factors with TOD were collected.The prevalence of any hypertensive target organ involvement among these subjects was high. In multivariable Logistic regressions adjusted for potentially confounding factors, older age, male gender, diabetes, EH grade 3, systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-C), were independently associated with coronary artery disease. Age, duration of EH, EH grade 3, SBP, pulse pressure (PP), and homocysteine (Hcy) were independently associated with cerebrovascular disease. Age, diabetes, duration of EH, EH grade 3, SBP, PP and estimated glomerular filtration rate (eGFR) were independently associated with chronic kidney disease. Male gender, EH grade 3 and SBP were independently associated with aortic dissection.The prevalence of hypertensive TOD is high in older Chinese hypertensive inpatients. Various cardiovascular risk factors are associated with hypertensive TOD. The level of SBP and severe hypertension (grade 3 hypertension) are common independent risk factors of TOD.

This study was aimed to investigate the therapeutic efficacy of HLH-2004 chemotherapy in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). 10 cases of sHLH treated with HLH-2004 regimen at our department were analyzed retrospectively. The results showed that 7 patients had clinical response to HLH-2004 regimen, while other 3 patients had no clinical response. 5 cases did not complete initial therapy of 8 weeks. Out of 5 cases, 4 died in the process of chemotherapy, 1 patient abandoned for serious side effects but finally acquired remission following 4 cycles of CHOP regimen. 5 cases underwent the whole courses of initial therapy. Out of 5 cases, 3 patients acquired remission, and other 2 were not well controlled. Out of the 3 patients who had achieved remission, one died of relapse, and other 2 patients kept remission. Out of the 2 patients who were not well controlled, one patient died, but another patient acquired remission after being discharged. It is concluded that patients with infection-associated hemophagocytic syndrome (IAHS) have high rates of remission after receiving HLH-2004 regimen combining with effective antibiotics. However, patients with HLH secondary to EBV (EBV-HLH) or lymphoma (LAHS) have low rates of remission or are easy to get relapse after remission.

To investigate the influence of in-hospital occurrence of organ failure on the prognosis of acute myocardial infarction (AMI) in 2 535 elderly patients of different age.A total of 2,535 patients with AMI were divided into different age groups or outcome groups, and the outcome or the incidence of in-hospital complications were reviewed in different groups.(1)The rate of in-hospital death was higher inor =80 years group (22.75%, 326/422) compared with that in 60-79 years group (12.26%, 1 854/2 113, chi (2)=42.15, P0.01). (2)Compared with the survivors (1,854 cases, 27.1%, 17.4%, 7.5%, 4.5%, 4.5%, 40.3%, 9.1%), patients who died in hospital (259 cases) were more likely to have cardiogenic shock (44.0%), Killp II-III heart function (28.2%), respiratory failure (14.3%), stroke (11.2%), renal failure (11.2%), cardiac arrhythmia (49.8%), and anemia (14.7%) in 60-79 years group (all P0.01). No difference in the rate of pulmonary infection (24.7% vs. 20.2%) and alimentary tract hemorrhage (5.8% vs. 3.9%) was found between two groups (both P0.05). The incidence of cardiogenic shock (28.1%), Killp II-III heart function (32.3%), respiratory failure (17.7%), renal failure (16.7%), alimentary tract hemorrhage (10.4%), cardiac arrhythmia (49.0%) and anemia (21.9%) was higher in non-survival group (96 cases) than that in survival group (326 cases, 12.9%, 21.2%, 9.2%, 5.2%, 2.1%, 35.0%, 10.1%, P0.05 or P0.01) in patientsor =80 years. There was no difference in the incidence of stroke (11.4% vs. 5.8%) and pulmonary infection (32.3% vs. 23.3%) between two groups (both P0.05). (3) The foremost four in-hospital complications in the non-survivors and survivors were cardiac arrhythmia, cardiogenic shock, Killp II-III heart function and pulmonary infection in 60-79 years group, but they were cardiac arrhythmia, pulmonary infection, Killp II-III heart function and cardiogenic shock inor =80 years group. When compared the cases of in-hospital death between these two different age groups, the incidence of cardiogenic shock was significantly lower in theor =80 years group (28.1% vs. 44.0%, P0.01). However, the incidence of sudden death was higher in theor =80 years group than that in 60-79 years group (22.92% vs. 7.34%, P0.01).The number and degree of in-hospital complications in elderly patients with AMI are increased by age. Cardiac arrhythmia is the major complication in elderly patients. For the patients 60-79 years old, it is more important to prevent and treat cardiogenic shock in order to improve the outcome in the 60-70 years group. In very old people with AMI, it is important to prevent sudden death.

To study the plasma natriuretic peptide (BNP) level in children with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD) and its correlation with left ventricular diastolic function.Doppler echocardiography was performed on 95 CHD children with PAH (PAH group) and on 42 CHD without PAH (control group). The plasma BNP level was measured using radioimmunity assay.Doppler echocardiography showed that the left ventricular end-diastolic diameter (LVDd), the right ventricular diameter end-diastolic (RVDd), and the pulmonary artery diameter (PAd) increased significantly in the PAH group compared with those in the control group (p0.05). The PAH group had higher velocity of tricuspid regurgitation (VTR) and higher pulmonary artery systolic pressure (PASP) than the control group (p0.05). The PAH group also had higher mitral A peak velocity (AV), higher mitral A peak velocity integral (AVI), higher E peak velocity intgral (EVI), and higher ratio of mitral AV to mitral E peak velocity (EV) and AVI/EVI ratio as well as prolonged left ventricular volumetric relaxation time than the control group. PASP was positively correlated with the AV/EV ratio (p0.05). The plasma BNP level in the PAH group increased significantly compared with that in the control group. In the PAH group, the plasma BNP level was positively correlated with the pulmonary artery pressure and the ratio of AV/EV.The left ventricular diastolic function is positively correlated with the plasma BNP level in children with PAH secondary to CHD. BNP may play an important role in the generation and development of left ventricular diastolic dysfunction induced by PAH.

Background and purpose CCLG-2008 protocol has been carried out for more than 5 years in most parts of China. This retrospective cohort study analyzed the clinical features and the role of prognosis index on the outcomes of patients with childhood acute lymphoblastic leukemia (ALL) treated by CCLG-2008 protocol in the Children's Hospital of Soochow University, Suzhou, China. Procedure From 2009 to 2013, 379 evaluable patients were enrolled in this protocol. ALL diagnosis was made by MICM and early prognosis index including age, gender, white blood cell (WBC), immunotype, molecular findings, karyotype and prednisone response were evaluated as predictors of adverse events by using SPSS 16.0. P-values Results The overall relapse treated with CCLG-2008 protocol was 17.4%, with 16.9% and 23.3% in B-ALL and T-ALL. Bone marrow, central nervous system and testis relapse counts for 95.4%, 3% and 1.52% respectively. Comparing with B-ALL (n=349), T-ALL (n=30) was associated with a high WBC (>100*109/L, P120 months, P=0.018), more adverse karyotype distribution, a poor prednisone response (P100*109/L) or increased age (>120 months) showed higher disease-relapse risk than other groups (P=0.003, 100*109/L. Patients with WBC < 50*109/L displayed the best survival while those with WBC higher than 100*109/L had the worst survival (Figure 1). The results of molecular alterations detected by multiple RT-PCR suggested that the MLL gene related and BCR-ABL positive patients exhibited the worst trend for EFS and OS (Figure 2a). Those with favorable karyotypes exhibited prolonged EFS and OS (Figure 2b). 44 cases who were not responsive well to prednisone displayed a shorter EFS and OS (Figure 3). Cox regression analysis indicated that WBC count, age, karyotype and prednisone response are independent factors as prognosis index for pediatric B-ALL treated by CCLG-2008 protocol . Conclusions Patients with T-ALL subtype often had higher risk factors, such as high WBC counts, increased age, adverse genes and karyotypes. It is more prone to resistance to prednisone and disease relapse, and has a poor survival outcome. WBC count, age, karyotype and prednisone response are independent factors in predicting prognosis at initial stage of B-ALL. Patients with either very high WBC ¡Ý100*109/L or older than 120 months have short survival and need more intensive therapy or novel drug combination regimen to improve their EFS and OS. Figure 1 EFS and OS of patients with different number of WBC. Patients with WBC >100*109/L have the shortest survival. Figure 1. EFS and OS of patients with different number of WBC. Patients with WBC >100*109/L have the shortest survival. Figure 2 a EFS and OS of B-ALL patients with fusion gene positive or negative. Figure 2. a EFS and OS of B-ALL patients with fusion gene positive or negative. Figure 2b EFS and OS of B-ALL patients with different risk of karyotype. Figure 3 EFS and OS of patients with different response to prednisone. Figure 3. EFS and OS of patients with different response to prednisone. Disclosures No relevant conflicts of interest to declare.

Background Hypertensive target organ damage (TOD) is the main reason for mortality or disability in older hypertensive patients. The studies on hypertensive TOD in Asia, especially in Chinese older hypertensive patients, are very limited. The aim of our study was to evaluate the prevalence and correlative factors of TOD in Chinese older hypertensive inpatients. Methods This is a retrospective survey and data were collected from the computerised medical files of hypertensive inpatients from January of 1993 to December of 2008. The analysis was done on 17682 inpatients, aged 60 years or older, with the diagnosis of essential hypertension (EH). The evidences of hypertensive TOD and associated factors with TOD were collected. Results The prevalence of any hypertensive target organ involvement among these subjects was high. In multivariable logistic regressions adjusted for potentially confounding factors, older age, male gender, diabetes, EH grade 3, SBP, LDL-C, were independently associated with coronary artery disease. Age, duration of EH, EH grade 3, SBP, PP and Hcy were independently associated with cerebrovascular disease. Age, diabetes, duration of EH, EH grade 3, SBP, PP and eGFR were independently associated with chronic kidney disease. Male gender, EH grade 3 and SBP was independently associated with aortic dissection. Conclusion The prevalence of hypertensive TOD is high in Chinese older hypertensive inpatients. Various cardiovascular risk factors are associated with hypertensive TOD. The level of SBP and severe hypertension (grade 3 hypertension) are common independent risk factors of TOD.

Background The data are inconsistent regarding whether extreme N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP) levels are associated with impaired renal function. Furthermore, the relationship between extreme NT pro-BNP levels and cardiac and renal function in elderly patients has not been reported. The aim of the present study was to examine a hypothesis that extreme NT pro-BNP levels may be associated with impaired cardiac and renal function in elderly patients. Methods We retrospectively analyzed the data of demographic, clinical, and echocardiographic features on 152 consecutive elderly patients aged more than 80 years old (average age, 83.65 ± 3.58 years) with NT pro-BNP levels ≥ 3000 pg/ml. The participants were divided into two categories according to their NT pro-BNP levels: (1) 3000–10000 pg/mL and (2) >10000 pg /mL. Results The number of patients with impaired renal function (P = 0.019) and the mortality (P 10000 pg /mL. The levels of serum creatinine and creatine kinase MB (CK-MB) in the group of NT pro-BNP > 10000 pg / mL were higher than those in the group of NT pro-BNP = 3000-10000 pg/mL (P = 0.001 and P = 0.023, respectively). Furthermore, no significant difference in the distribution by NYHA class in different NT pro-BNP levels was observed. Multiple linear regression analyses demonstrated that with NT pro-BNP levels as the dependent variable, NT pro-BNP levels were positively correlated with CK-MB (β = 0.182, P = 0.024) and creatinine levels (β = 0.281, P = 0.001). The area under the receiver-operating characteristic (ROC) curve of NT pro-BNP levels and clinical diagnosis of impaired renal function was 0.596 and reached significant difference (95%CI:0.503-0.688, P = 0.044). Conclusion These data suggest that the extreme elevation of NT pro-BNP levels (≥3000 pg/ml) is mainly determined by impaired renal function in elderly patients above 80 years. Extreme NT pro-BNP levels may be useful for assessing the severity of impaired renal function.