Patterns of multimorbidity in hospitalized older adults based on factor analysis / 中华老年医学杂志

Objective:To explore the multimorbidity patterns in older inpatients adults, and their differences between Northern and Southern China.Methods:A total of 4 348 elderly patients aged 60 and above from the geriatrics departments of 12 grade A tertiary hospitals in 7 cities in China were investigated.Factor analysis was used to explore the comorbidity patterns and analyze the differences in comorbidity patterns between Southern and Northern China.Results:The study population consisted of 4 348 patients over the age of 60, with an average age of(74.15±8.01)years.The total sample had a Kaiser-Meyer-Olkin(KMO)sampling adequacy index of 0.657 and a cumulative variance percentage of 43.97%.Factor analysis revealed there were five major multimorbidity patterns in the patients.These were: the metabolic pattern; the liver-kidney pattern; the degenerative pattern; the neuropsychiatric pattern; dementia.Further factor analysis for the South and the North was conducted.Older inpatients in Southern regions had a KMO sampling adequacy index of 0.654 and a cumulative variance percentage of 43.50%.In Southern China, the multimorbidity patterns were similar to the overall patterns.In Northern regions, older inpatients had a KMO sampling adequacy index of 0.648 and a cumulative variance percentage of 45.16%.The liver-kidney pattern, metabolic disease pattern, lung-dementia pattern, degenerative disease pattern, and neuropsychiatric pattern were the main multimorbidity patterns in Northern China.Conclusions:Multimorbidity patterns were different between Northern and Southern China and should be differentiated in their management.In the North, older adults should pay more attention to the prevention and management of respiratory system diseases and dementia, while in the South, older adults should pay more attention to the prevention and management of degenerative disease.Early disease prevention based on multimorbidity patterns is one of the approaches to the reduction of chronic diseases in older adults.

Drug therapy and mechanism of pain in mice with induced adenomyosis / 中国实验动物学报

Objective To investigate the effects of different drugs and to explore the mechanism of pain in mice with adenomyosis ( ADM) .Methods The mouse model of adenomyosis was induced by oral administration of tamoxifen. The vaginal smear was examined by cytology, and serum levels of 5-HT, GnRH-R, NGF and NF were determined.Results Higher level of 5-HT was detected in the controls compared with the models.The expression of GnRH-R and NGF in nor-mal endometrium and eutopic endometrium were significantly lower than those in ectopic endometrium.The expression on NF in normal endometrium was significantly lower than that in the eutopic and ectopic endometria.Conclusions Similar with regular dose of GnRH-a, half dose of GnRH-a can slow down the progress of ADM as well as reducing pain.Combina-tion of regular dose of GnRH-a and Diane-35 could consolidate the therapeutic effect and even achieve pathological cure.5-HT may take an active part in the mechanism of pain in ADM.

Feasibility of Low Tube Voltage Combined with Low Contrast Dose in 64-slice Spiral CT Cerebral and Carotid Arteriography / 中国医学影像学杂志

PurposeTo evaluate the feasibility of a low-dose contrast medium protocol for 64-slice spiral CT angiography (CTA) of cerebral and carotid using a low-tube-voltage setting, and to compare the display effect of cerebral and carotid arteries by low-tube-voltage low-dose contrast medium and routine-tube-voltage routine-dose contrast medium scanning, and to assess the effect on radiation dose.Materials and MethodsEighty consecutive patients were prospectively selected to perform cerebral and carotid CTA inspection. The patients were randomly divided into control group and low dose group with 40 people in each group. The voltage in control group was 120 kV and the contrast agent was 80 ml; those in low dose group were 80 kV and 50 ml, respectively. The artery image quality was evaluated and venous interference was scored. The CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose in both groups were statistically analyzed.Results The consistency of uniform in artery image quality score and venous interference score was rather high according to the assessment of two physicians (Kappa=0.782 and 0.867). There was no statistical difference in artery image quality score, venous interference score, SNR and CNR between the two groups (Z=-0.864--0.032,P>0.05). The CT value in low dose group was higher than that in control group (differences with statistical significance,t=-8.789-1.715,P<0.05). The CT dose index of volume, dose-length product and effective dose in low dose group were all signiifcantly lower than those in control group (Z=-8.888,t=78.092 and 78.350, respectively,P<0.05).Conclusion The use of low tube voltage and low contrast dose in cerebral and carotid CTA examination can result in high quality images which meets the diagnostic needs and obviously reduce radiation dosage.

Application of three-dimensional cell culture model in cancer research / 国际肿瘤学杂志

Compared to the conventional two-dimensional (2D) culture,in vitro three-dimensional cell culture (3DCC) can mimic the microenvironment more exactly.Compared to in vivo animal models,3DCC is less time-consuming and can be real-time recorded.Thus,3DCC fills the gap between 2D culture and animal models,which is used for oncologic research quickly.In 3DCC,the characteristics of cancer cells,such as morphology,the capability of invasion and migration and the resistance to chemo-radiotherapy,are quite different from those in 2D culture.The development of 3DCC technology provides a platform for oncology,organization engineering and gene or drug screening.

Changes and prognostic significance of bone marrow oil drop and megakaryocyte counts of the bone marrow in acute myeloid leukemia patients (non-M3) / 白血病·淋巴瘤

Objective To investigate the changes and prognostic significance of bone marrow(BM) oil drop and megakaryocyte counts after chemotherapy in acute myeloid leukemia (AML) patients (non-M3).Methods Ninty-nine adult patients with denovo AML (non-M3) were retrospectively analyzed to evaluate the change of BM oil drop and megakaryocyte counts and their influences on overall survival(OS) and disease free survival (DFS) during all stages of standardized therapy.Results The median DFS and OS were 21 (2-88);months and 70 (4-89) months,respectively; and 3-year predicted DFS and OS were 47.3 ％ and 55.8 ％,respectively.After AML patients (non-M3) achieving complete remission (CR) by induction therapy,BM oil drop tended to increase along with postremission chemotherapy cycle accumulation, while megakaryocyte counts tended to decrease.The univariate analysis indicated that megakaryocyte counts decreased after the second course of postremission therapy. BM oil drop increased after the first to the third course of postremission therapy.Grade of myelofibrosis in BM biopsy,serum lactate dehydrogenase (LDH) level at diagnosis,flow cytometric immunophenotyping, the percentage of BM blast cells at diagnosis and the percentage of residual leukemic cells (RLC) during aplasia (7-10 days after the end of induction therapy) had prognostic significance.Multivariable COX analysis indicated the percentage of BM blast cells at diagnosis and change of BM oil drop after the third postremission therapy were independent prognostic factors for DFS (P =0.010,0.018 respectively),and RLCs during aplasia and change rate of the megakaryocyte counts after the second postremission therapy were independent prognostic factors for OS (P =0.009, 0.038respectively).Conclusion After AML patients (non-M3) achieving CR by induction therapy,BM oil drop tends to increase along with postremission chemotherapy cycles accumulation,while the megakaryocyte counts tend to decrease.Dynamic observations of bone marrow oil drop and megakaryocyte counts are helpful for assessing the prognosis of acute myeloid leukemia (non-M3).