石家庄市社区综合干预预防老年人跌倒的效果评价

目的 了解石家庄市社区老年人跌倒的发生情况,并评价预防老年人跌倒干预措施的效果。方法 采用分层随机抽样方法,于2012年随机抽取石家庄市桥西区维明社区60岁及以上、居住至少满1年的836名老年人作为调查对象,进行基线调查,然后每年对社区老年人进行预防跌倒的社区综合干预,2015年再次对相同社区老年人的跌倒情况进行随访调查。结果 干预后跌倒发生率（5.7%）低于干预前（11.6%）;干预后调查对象关于"跌倒可以预防","老年人选择老花镜时是否需要验光后购买","老年人跌倒后是否应该马上扶起"的知晓率均高于干预前（均有P<0.001）,干预后调查对象在预防跌倒相关行为中关于"采取措施预防跌倒","没有因为担心跌倒而减少自己的日常活动或运动"比例均高于干预前（均有P<0.001）。结论 对社区老年人实施社区综合干预能够提高老年人预防跌倒知识知晓率及相关行为比例,并能有效降低跌倒的发生率。     

Bone marrow involvement in small cell lung cancer: Prognostic significance and correlation with hematological and biochemical parameters

The more metastatic sites and bone marrow metastasis in small cell lung cancer (SCLC), the worse the prognosis. Diagnosing the bone marrow invasion at the beginning of the therapy is important for determining of the prognosis and planning the treatment. Abnormalities of some blood parameters may help to estimate the extent of bone marrow invasion by cancer cells. In this retrospective review, the changes in routine laboratory tests that may indicate bone marrow invasion, the predictive values of these tests, and the prognostic importance of bone marrow invasion were evaluated in SCLC patients who were being followed up according to a protocol. One hundred and forty‐four patients with SCLC were enrolled in this study. Retrospectively, it was evaluated that 25 (17.4%) of the patients had bone marrow metastasis. According to univariate analysis, there was a significant difference between hemoglobin, white blood cell count, platelet count, lactate dehydrogenase, alkaline phosphatase and uric acid of the patients with and without bone marrow involvement. Among the biochemical parameters, the elevated LDH and AP had the highest sensitivity and specificity as indicators of bone marrow invasion (0.80–0.82 and 0.84–0.78, respectively). The median overall survival of extensive‐stage disease with and without bone marrow metastasis were 4.0 ± 1.0 months (95% CI 2.2–5.7) and 7.0 ± 1.2 months (95% CI 4.7–9.3), respectively (P = 0.03). Bone marrow metastasis was found to be an indicator of a bad prognosis. Bone marrow biopsy, that is an invasive procedure, can be performed on selected patients who have changes of routine laboratory tests suggesting bone marrow invasion.     

Potentiation of fibroblast DNA synthesis by a phenytoin-induced mononuclear cell derived factor in vitro

Abstract – Human mononuclear cells purified by Lymphoprep flotation were incubated with phenytoin (PHT) (20 μg/ml) or its metabolite p-HPPH (2 μg/ml) in the presence of Concanaval-in A (10 μg/ml) in vitro. The results indicate that phenytoin and its metabolite p-HPPH induce the release of a mononuclear cell factor(s) that activates quiescent human gingival fibroblast to synthesize DNA.     

Intra-arterial digital subtraction angiography of the spinal cord

Digital subtraction angiography (DSA) of the spinal cord was performed in 6 patients using selective intra-arterial injections of contrast material. Two arteriovenous malformations of the spinal cord, 1 dural fistula, and 1 case of multiple hemangioblastomas were studied. Contrast and spatial resolution were satisfactory for defining normal and abnormal vascularity while reducing examination time, contrast dosage, patient discomfort, and film cost. The only significant limitation was misregistration artifacts seen on lateral views encompassing the diaphragm.