Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

Conversion therapy of a giant hepatocellular carcinoma with portal vein thrombus and inferior vena cava thrombus:A case report and review of literature

BACKGROUND The prognosis of hepatocellular carcinoma(HCC)combined with portal and hepatic vein cancerous thrombosis is poor,for unresectable patients the combination of targeted therapy and immune therapy was the first-line recommended treatment for advanced HCC,with a median survival time of only about 2.7-6 months.In this case report,we present the case of a patient with portal and hepatic vein cancerous thrombosis who achieved pathologic complete response after conversion therapy.CASE SUMMARY In our center,a patient with giant HCC combined with portal vein tumor thrombus and hepatic vein tumor thrombus was treated with transcatheter arterial chemoembolization(TACE),radiotherapy,targeted therapy and immunotherapy,and was continuously given icaritin soft capsules for oral regulation.After 7 months of conversion therapy,the patient's tumor shrank and the tumor thrombus subsided significantly.The pathology of surgical resection was in complete remission,and there was no progression in the postoperative follow-up for 7 months,which provided a basis for the future strategy of combined conversion therapy.CONCLUSION In this case,atezolizumab,bevacizumab,icaritin soft capsules combined with radiotherapy and TACE had a good effect.For patients with hepatocellular carcinoma combined with hepatic vein/inferior vena cava tumor thrombus,adopting a high-intensity,multimodal proactive strategy under the guidance of multidisciplinary team(MDT)is an important attempt to break through the current treatment dilemma.

Endoscopic treatment of extreme esophageal stenosis complicated with esophagotracheal fistula: A case report

BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.

Stenting versus non-stenting treatment of intermediate stenosis culprit lesion in acute ST-segment elevation myocardial infarction： a multicenter random- ized clinical trial

Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction （STEMI） patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. Methods and results It was a pro- spective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate （40%-70%） stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban （15 pg/kg） were enrolled and were randomly assigned （h 1） to stenting group （n = 201） and non-stenting group （n = 198）. In stenting group, patients received pharmacologic therapy plus standard percutaneous coronary intervention （PCI） with stent implantation. In non-stenting group, pa- tients received pharmacologic therapy and PCI （thrombectomy）, but without dilatation or stenting. Primary endpoint was 12-month rate of major adverse cardiac and eerebrovascular events （MACCE）, a composite of cardiac death, non-fatal myocardial infarction （M1）, repeat re- vascularization and stroke. Secondary endpoints were 12-month rates of all cause death, ischemia driven admission and bleeding complica- tion. Median follow-up time was 12.4 ~ 3.1 months. At 12 months, MACCE occurred in 8.0% of the patients in stenting group, as compared with 15.2% in the non-stenting group （adjusted HR： 0.42, 95% Ch 0.19-0.89, P = 0.02）. The stenting group had lower non-fatal MI rate than non-stenting group, （1.5% vs. 5.5%, P = 0.03）. The two groups shared similar cardiac death, repeat revascularization, stroke, all cause death, ischemia driven readmission and bleeding rates at 12 months. Conclusions Stent implantation had better efficacy and safety in reducing MACCE risks among acute STEMI patients with single vessel intermediate stenosis culprit lesions.

2019 Chinese guideline for the management of hypertension in the elderly

Table of contents Preamble 1 Introduction 1.1 Class of recommendations and level of evidences 1.2 Definition and categories of hypertension in the elderly 1.3 Current status of epidemiology of hypertension in the elderly 1.4 The characteristics of hypertension in the elderly.

Evaluation method and optimization strategies of resilience for air&space defense system of systems based on kill network theory and improved self-information quantity

Resilience of air&space defense system of systems(SoSs)is critical to national air defense security.However,the research on it is still scarce.In this study,the resilience of air&space defense SoSs is firstly defined and the kill network theory is established by combining super network and kill chain theory.Two cases of the SoSs are considered:(a)The kill chains are relatively homogenous;(b)The kill chains are relatively heterogenous.Meanwhile,two capability assessment methods,which are based on the number of kill chains and improved self-information quantity,respectively,are proposed.The improved self-information quantity modeled based on nodes and edges can achieve qualitative and quantitative assessment of the combat capability by using linguistic Pythagorean fuzzy sets.Then,a resilient evaluation index consisting of risk response,survivability,and quick recovery is proposed accordingly.Finally,network models for regional air defense and anti-missile SoSs are established respectively,and the resilience measurement results are verified and analyzed under different attack and recovery strategies,and the optimization strategies are also proposed.The proposed theory and method can meet different demands to evaluate combat capability and optimize resilience of various types of air&space defense and similar SoSs.

Esophageal variceal pressure influence on the effect of ligation

AIM: To explore the effect of in vitro porcine esophageal variceal pressure on complete ligation degree for polycyclic ligators. METHODS: An in vitro model of experimental porcine venous vessels was used to test various venous pressures. Three treatment groups were designated according to the preset pressure range: P1 = 25-30 cm H2O; P2 = 35-40 cm H2O; P3 = 45-50 cm H2 O. The effect of pressure on ligation was assessed and compared among the groups. RESULTS: Complete ligation was achieved at a rate of 56.25%(18/32) in group P1, 37.5%(12/32) in group P2, and 33.33%(11/33) in group P3(χ2 = 3.6126; P = 0.0573). CONCLUSION: Higher variceal pressures impair the ligation completion rate. Therefore, measuring variceal pressure may help predict the effect of endoscopic ligation and guide treatment choice.

Research on tune feedback of the Hefei Light SourceⅡbased on machine learning

The theory of tune feedback correction and the principle of a feedback algorithm based on machine learning are introduced,with a focus on the application of lasso regression for tune feedback correction.Simulation verification and online feedback correction results are presented.The results show that,after applying machine learning,the feedback accuracy of the tune feedback system was higher,and the betatron tune stability was further improved.

A preliminary study on photogrammetry for the FAST main reflector measurement

The Five-hundred-meter Aperture Spherical radio Telescope(FAST) is the largest single-dish radio telescope in the world. In this paper, we apply photogrammetry to measure local area surface accuracy of the FAST main reflector. Contrast with the existing photogrammetric methods that need to stick the cooperation target on the panel. In this paper, we directly detect nodes according to their natural feature. Analyzing the FAST reflector composition, we propose a two-step Hough transform method for node detection. Due to the high similarity of the neighboring area around nodes, it is hard to match two images by the feature matching method. Therefore, we apply the nodes combination approach to obtain the homography matrix between two photos for nodes matching. After nodes detection and matching,triangulation and bundle adjustment algorithms are adopted for 3 D reconstruction. During the experiment,the adjusted node position deform a local area of the FAST main reflector into a spherical cap with a radius of 300 m. The experimental result shows that the measurement accuracy of the sphere with a radius of 300 m is 12.299 mm, indicating that it is feasible to apply photogrammetry for the FAST main reflector measurement.

Roles of Tregs in development of hepatocellular carcinoma:A meta-analysis

AIM: To assess systematically the association between regulatory T cells (Tregs) and hepatocellular carcinoma (HCC).

双倍剂量链霉蛋白酶联合西甲硅油改善胃内清洁度的临床研究

背景胃清洁度是影响胃镜检查质量的重要因素.链霉蛋白酶是一种蛋白分解酶,可切断胃粘膜中的黏蛋白肽键,提高胃清洁度.双倍剂量的链霉蛋白酶可充分发挥祛除黏液疗效,联合西甲硅油可进一步提升胃内视野.目的探讨双倍剂量链霉蛋白酶联合西甲硅油在改善胃镜检查胃内清洁度方面的疗效和安全性.方法采用随机对照的方法,将126例接受胃镜检查的患者分为三组:不含链霉蛋白酶的对照组、单倍剂量链霉蛋白酶组和双倍剂量链霉蛋白酶组.观察各组在检查时胃内不同部位的清洁度、内镜操作时间、病灶检出率及不良反应等指标.结果与对照组相比,双倍链霉蛋白酶组的胃内清洁度评分更高(P<0.01),内镜操作时间更短(P<0.01),但病灶检出率没有显著差异.同时,各组在不良反应发生率上也没有显著差异(P>0.05).结论双倍剂量链霉蛋白酶优于单倍剂量链霉蛋白酶作为胃镜检查术前准备药物,能够明显改善胃内清洁度,减少内镜操作时间,并且具有较高的安全性.

Chinese expert consensus on the management of hypertension in the very elderly

Population aging has become a major challenge for the healthcare in China. More than 23 million Chinese are cur- rently ≥ 80 years, with an annual increase of 5%. The Chi- nese population of 80 years or older is expected to reach 30.67 million by 2020 and 74 million by 2040.

Laparoscopic-assisted endoscopic full-thickness resection of a large gastric schwannoma: A case report

BACKGROUND Schwannomas,also known as neurinomas,are benign tumors derived from Schwann cells.Gastrointestinal schwannomas are rare and are most frequently reported in the stomach.They are usually asymptomatic and are difficult to diagnose preoperatively;however,endoscopy and imaging modalities can provide beneficial preliminary diagnostic data.There are various surgical options for management.Here,we present a case of a large gastric schwannoma(GS)managed by combined laparoscopic and endoscopic surgery.CASE SUMMARY A 28-year-old woman presented with a 2-mo history of epigastric discomfort and a feeling of abdominal fullness.On upper gastrointestinal endoscopy and endoscopic ultrasonography,a hypoechogenic submucosal mass was detected in the gastric antrum:It emerged from the muscularis propria and projected intraluminally.Computed tomography showed a nodular lesion(4 cm×3.5 cm),which exhibited uniform enhancement,on the gastric antrum wall.Based on these findings,a preliminary diagnosis of gastrointestinal stromal tumor was established,with schwannoma as a differential.Considering the large tumor size,we planned to perform endoscopic resection and to convert to laparoscopic treatment,if necessary.Eventually,the patient underwent combined laparoscopic and gastroscopic surgery.Immunohistochemically,the resected specimen showed positivity for S-100 and negativity for desmin,DOG-1,α-smooth muscle actin,CD34,CD117,and p53.The Ki-67 index was 3%,and a final diagnosis of GS was established.CONCLUSION Combined laparoscopic and endoscopic surgery is a minimally invasive and effective treatment option for large GSs.

Association between drinking behavior and sleep duration in Chinese adults: findings from the China Health and Nutrition Survey

Background:To examine the association between alcohol drinking and short sleep duration among Chinese adults.Methods:Based on inclusion and exclusion criteria,28,167 records of 15,074 adults longitudinal data were obtained from the China Health and Nutrition Survey for the period from 2004 to 2011.A multilevel logistic regression model was employed to explore the association between alcohol drinking and sleep duration.Results:Compared with nondrinking participants,a high drinking frequency was positively correlated with a short sleep duration in both the males(odds ratio(OR)=1.33,95%confidence interval(CI)=1.20–1.48,P<0.001)and females(OR=1.60,95%CI=1.18–2.18,P=0.003)before the covariates were adjusted.After adjusting for age,residence area,education level,marital status,smoking,coffee consumption,tea consumption,and activity level,this association remained significant in the males(OR=1.31,95%CI=1.17–1.46,P<0.001)but not in the females(OR=1.16,95%CI=0.85–1.59,P=0.340).Conclusion:The present results suggest that a high drinking frequency was positively correlated with a short sleep duration in male population.Comprehensive measures therefore need to be implemented to improve sleep duration,especially to increase awareness of the dangers of drinking alcohol.

Ligand Steric Effects on Naphthyl-α-diimine Nickel Catalyzed α-Olefin Polymerization

Naphthyl-α-diimine nickel complexes with systematically varied ligand sterics, activated by modified methylaluminoxane（MMAO）, were tested in the polymerization of higher α-olefin（1-hexene, 1-decene and 1-hexadecene） under suitable conditions. The polymerization results indicated the possibility of precise microstructure control, depending on catalyst structure, polymerization temperature, monomer concentration and types of monomers, which in turn strongly affects the resultant polymer properties. Naphthyl-α-diimine nickel complex bearing chiral bulky sec-phenethyl groups in the o-naphthyl position showed good catalytic activity, and resulted in branched polymers（42-88/1000 C） with high molecular weights（Mn：（4.3-15.2） × 10^4 g·mol^-1） and narrow molecular weight distribution（Mw/Mn = 1.13-1.29, RT）, which suggested a living polymerization. The increasing steric hindrance of catalyst leads to enhance insertion for 2,1-insertion of α-olefin and the chain-walking reaction.

Immunotherapy-related toxicity in lung cancer: clinical characteristics and managing strategy

Worldwide,lung cancer is the most common malignancy and the leading cause of cancer-related death.After the era of chemotherapy,radiotherapy,and molecular-targeted therapy,the treatment of advanced lung cancer has entered a new era of immunotherapy,represented by immune checkpoint inhibitors(ICIs),including programmed cell death protein-1/programmed cell death protein ligand-1(PD-1/PD-L1)inhibitors and cytotoxic T-lymphocyte-associated antigen-4(CTLA-4)inhibitors.[1]However,patients treated with ICIs may experience unexpected systemic toxicities,some fatal.Thus,managing immunotherapy-related toxicity has become increasingly significant in patients with lung cancer.Here,we review the latest developments on the clinical features and management of immunotherapy-related toxicity in patients with lung cancer in order to promote the standardization of immunotherapy for lung cancer.

Fabrication of titanium nitride nanoparticles onto carbon nanotubes by atomic layer deposition for utilization as Pt electrocatalyst supports

Because of its good stability and conductivity,titanium nitride(TiN)is considered to be a very promising alternative support for Pt catalyst;however,the preparation of TiN supports is still challenging.In this work,atomic layer deposition was facilely adopted to fabricate TiN nanoparticles onto carbon nanotubes(CNTs),and then the prepared TiN/CNTs hybrid was used as a support of Pt catalyst.The resulting TiN/CNTs-supported Pt nanoparticles(Pt@TiN/CNTs)nanocomposite showed higher catalytic activity and long-term stability toward the oxygen reduction reaction than the commercial Pt/C,which should be due to the high conductivity and high stability of TiN support,as well as the favorable Pt-TiN strong interaction.

Quantifying the impacts of human mobility restriction on the spread of coronavirus disease 2019:an empirical analysis from 344 cities of China

Background:Since the outbreak of coronavirus disease 2019(COVID-19),human mobility restriction measures have raised controversies,partly because of the inconsistent findings.An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction.The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.Methods:Our study applied the difference-in-difference(DID)model to assess the declines of population mobility at the city level,and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.Results:The DID model showed that a continual expansion of the relative declines over time in 2020.After 4 weeks,population mobility declined by-54.81%(interquartile range,-65.50%to-43.56%).The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks(ie,1%decline of population mobility was associated with 0.72%[95%CI:0.50%-0.93%]reduction of cumulative cases for 1 week,1.42%2 weeks,1.69%3 weeks,1.72%4 weeks,1.64%5 weeks,and 1.52%6 weeks).The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter.The effects on cumulative cases differed by cities of different population sizes,with greater effects seen in larger cities.Conclusions:Persistent population mobility restrictions are well deserved.Implementation of mobility restrictions in major cities with large population sizes may be even more important.

Application of the Next-Generation Sequencing Technology to Reveal Mechanism of Small Cell Lung Cancer Transformation from Adenocarcinoma

To the Editor：Small cell lung cancer （SCLC） transformation is one of the most common mechanisms of resistance to epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs） in non-SCLC （NSCLC）.However,whether such transformation is one from NSCLC to SCLC or the coexistence of both remains controversial.[1] In this study,we performed next-generation sequencing （NGS） with a panel of 168 tumor genes for consecutive repeat biopsy tissue samples of a lung adenocarcinoma patient harboring EGFR exon 19 deletion （ex19del）.

A novel endogenous badnavirus exists in Alhagi sparsifolia

We report the recovery of a 7068-nt viral sequence from the ＂viral fossils＂ embedded in the genome of Alhagi sparsifolia, a typical desert plant. Although the full viral genome remains to be completed, the putative genome structure, the deduced amino acids and phylogenetic analysis unambiguously demonstrate that this viral sequence represents a novel species of the genus Badnavirus. The putative virus is tentatively termed Alhagi bacilliform virus （ABV）. Southern blotting and inverse polymerase chain reaction （PCR） data indicate that the ABV-related sequence is integrated into the A. sparsifolia genome, and probably does not give rise to functional episomal virus. Molecular evidence that the ABV sequence exists widely in A. sparsifolia is also presented. To our knowledge, this is the first endogenous badnavirus identified from plants in the Gobi desert, and may provide new clues on the evolution, geo- graphical distribution as well as the host range of the badnaviruses.