老年人的健康问题除了我们熟知的年龄老化、共病增多的问题,更伴有其他多种老年综合征,如营养不良、认知能力下降、焦虑/抑郁、谵妄、尿失禁、便秘、衰弱、多重用药、睡眠障碍、跌倒、压力性溃疡、视力/听力障碍、受虐等问题. 这些老年综合征是除外典型慢性病(如糖尿病、高血压、冠心病等)外,另一种严重影响老年人功能及健康状态的重要因素,而在传统医疗模式中往往不能被及时发现并干预治疗〔1〕. 相对于专注于疾病评估及各种慢病管理的传统医疗模式,囊括了疾病状况及心理健康等问题的现在老年病管理模式更具有优势〔2〕,且传统医疗评估不能反映躯体功能、精神心理及社会环境等方面问题,需要一个更全面的评估方法以发现老年人潜在的问题,这就需要对老年人进行老年综合评估( CGA)〔3〕.本文对CGA工具的研究进展进行综述.

This study aimed to investigate the incidence, remission and risk factors of non-alcoholic fatty liver disease (NAFLD) among a general population with a 6-year follow-up. In total, 691 individuals from the general population in Jilin, China aged 20–75 years participated in two independent cross-sectional surveys carried out in 2007 and 2013. After excluding patients with alcoholism, viral hepatitis and other liver diseases, 646 individuals were finally enrolled in our study. Of the 646 subjects, 512 did not have NAFLD at baseline, while 134 did. Of the 512 individuals without NAFLD at baseline, 188 (36.7%) developed NAFLD during the six-year follow-up period. The baseline body mass index (BMI, OR = 1.49, 1.36–1.64), high-density lipoprotein cholesterol level(HDL-C) (OR = 0.35, 0.16–0.76) and weight gain (OR = 1.22, 1.16–1.29) were independent predictors for NAFLD incidence. Of the 134 subjects with NAFLD at baseline, 33 (24.6%) had no evidence of NAFLD after 6 years. Males (OR = 4.85, 1.98–11.92) and baseline BMI levels (OR = 0.81, 0.70–0.94) were associated with NAFLD remission. Among the general population, the incidence of NAFLD mainly depended on baseline weight and weight gain. Subjects with mild baseline weights and male subjects were prone to NAFLD remission.

Obesity and obesity-related diseases are important public health challenges. In this study, we aimed to provide updated trends in the prevalence of these conditions. We conducted two independent cross-sectional surveys of the general population aged 20–75 years in 2007 and 2013 in Jilin, China. A total of 3636 (1719 males) and 1359 (602 males) participants were enrolled in the 2007 and 2013 surveys, respectively. Obesity-related diseases were defined as type 2 diabetes, hypertension, dyslipidemia and non-alcoholic fatty liver disease (NAFLD). The age-standardized prevalence of obesity, overweight, diabetes, pre-diabetes, dyslipidemia and NAFLD increased from 2007 to 2013 from 15.82% to 19.41%, 35.85% to 41.80%, 6.37% to 9.23%, 16.77% to 23.49%., 53.46% to 65.50%, and 23.48% to 44.31% in males, respectively, and from 13.18% to 18.77%, 31.11% to 37.54%, 4.41% to 8.48%, 8.10% to 16.49%, 41.96% to 54.70%, and 17.56% to 43.06% in females, respectively. However, the prevalence of hypertension remained stable (males: 38.10% vs. 38.63% and females: 33.04% vs. 33.01% in 2007 and 2013, respectively). The prevalence of obesity and obesity-related diseases, except for hypertension, increased significantly in the general population in Northeastern China. More targeted measures should be implemented to address the serious challenges presented by these diseases.

In this paper, we study a non-characteristic Cauchy problem for a radially symmetric inverse heat conduction equation in a two-layer domain. This is a severely ill-posed problem in the sense that the solution (if it exists) does not depend continuously on the data. It is well-known that the classical Tikhonov regularization solutions are too smooth and the approximate solutions may lack details that might be contained in the exact solutions. Combining Fourier transform technique with a modified version of the classical Tikhonov regularization, we obtain a regularized solution which is stably convergent to the exact solution with a sharp error estimate.

Background Cardiovascular risk factors tend to be clustered. Variations in clusters across populations have not been widely investigated. This study aims to compare the prevalence and clustering of major cardiovascular risk factors between adults in the Netherlands and China.Methods A total of 6542 Dutch adults was recruited from 2001 to 2006 for the Utrecht Health Project, an ongoing cohort study among inhabitants of a newly developing area near Utrecht, the Netherlands. A total of 37,141 Chinese employees who received health screening in Changchun City, China was enrolled from 2003 to 2010, and 3850 residents from Dehui, another city from northeast China, were enrolled in 2007.Results The Dutch and Chinese populations shared similar patterns with increasing prevalence with age for most cardiovascular risk factors. Age-specific levels of body mass index, blood pressure and total cholesterol were higher in the Dutch than in the Chinese population. An exception to this was young men (18-44 years old): Chinese young men had similar body mass index levels compared to their Dutch counterparts. The age-standardised prevalence of current smoking was much higher in Chinese men compared to Dutch men (P<0.05). The clustering patterns of risk factors differed between the Dutch and Chinese with the smoking-heavy drinking cluster while smoking-hypercholesterolemia was more common in both Dutch young men and women.Conclusions Cardiovascular risk profiles and clustering patterns differ between the Dutch and the Chinese and seem to differ between men and women. This calls for race and sex-specific targeted prevention programmes.

非酒精性脂肪性肝病（NAFLD）是一种组织病理学改变与酒精性脂肪肝相似的慢性肝脏疾病，可发生在少量饮酒或不饮酒的个体。是除外酒精和其他明确的导致肝损伤因素所致的脂肪性肝病，可进展为肝纤维化、肝硬化和终末期肝病［1］，是隐源性肝硬化的重要病因之一。疾病谱包括非酒精性单纯性脂肪肝（NAFL）、非酒精性脂肪型肝炎（NASH）及其相关肝硬化，并可诱发肝细胞癌。值得注意的是，发展到肝硬化时，脂肪变程度往往出现下降。NAFLD 多缺乏特异性表现，往往不易被发现，或因症状轻微不被人们重视。在我国脂肪性肝病出现的较晚，其所致的肝硬化、肝癌尚少见，但应引起医务人员和民众警惕。

AIM: To determine the upper cut-off values of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in a Northern Chinese population.METHODS: A total of 3769 subjects in Jilin Province Northeast China were stratified to determine the potential factors affecting serum ALT and AST levels. The upper cut-off values of serum ALT and AST in these subjects were determined using receiver operating characteristic analysis and their sensitivity and specificity were evaluated.RESULTS: Stratification analysis revealed that serum ALT and AST levels were associated with gender, alcohol consumption, serum cholesterol and triglyceride levels, and body mass index. The upper cut-off values of serum ALT and AST were 22.15 U/L and 25.35 U/L for healthy men and 22.40 U/L and 24.25 U/L for healthy women, respectively. The new cut-off values had a higher sensitivity, but a slightly lower specificity than the current standards.CONCLUSION: Our results indicate that the new upper cut-off values of serum ALT and AST are markedly lower than current standards and may be valuable for the evaluation of liver function.

非酒精性脂肪性肝病（ NAFLD）无长期大量饮酒史，脂肪在肝脏过度堆积引起，病变主要在肝小叶，病理特征由轻到重依次为肝脂肪变、非酒精性脂肪性肝炎（ NASH）、肝纤维化和肝硬化，临床上以肝脂肪变和NASH最为常见。该病大部分呈慢性良性过程，但并不完全处于静止状态，严重时可出现相应的肝内及全身并发症〔1～5〕。 NAFLD成为近年来研究的热点问题，是危害人类健康的三大肝病之一，并逐渐被广泛认识。

To evaluate the prevalence, awareness, treatment and control of hypertension and its risk factors in Dehui City of Jilin Province in China. The study was performed among 3778 subjects (male=1787) in Dehui City, Jilin Province of China. The subjects completed a standard questionnaire, biochemical tests and physical examinations. Logistic regression analyses were used to identify risk factors for hypertension. The prevalence of hypertension was 41.00% in this area. The awareness, treatment and the control of hypertension were 21.82, 15.56 and 1.10%, respectively, with city areas being significantly higher than rural areas. Significant risk factors for hypertension included age, sex, central obesity, alcohol consumption, family history of hypertension, dyslipidemia, education level and type of work. Further analysis showed that diabetes for urban participants and cigarette smoking for rural participants were risk factors but were not statistically significant at the multi-variate level. The prevalence of hypertension in Dehui Ctiy of Jilin Province is higher than in other areas of China. In addition, rates of awareness and treatment of the condition are much lower than in other populations, with the control rate only 1.10%.

目的 检测Mda7基因联合放射线抑制前列腺癌PC-3细胞生长的作用.方法 PC-3细胞接受不同剂量X-射线照射,流式细胞术检测细胞凋亡；pcDNA-Mda7质粒转染PC-3细胞,流式细胞术检测细胞凋亡,集落形成法检测细胞生长；pcDNA-Mda7质粒与X-射线联合应用,流式细胞术检测细胞凋亡.结果 PC-3细胞凋亡率随X-射线照射剂量升高而增高,在10 Gy及以上剂量照射细胞凋亡率明显高于对照组(P＜0.01)；pcD-NA-Mda7质粒转染PC-3细胞,细胞凋亡率明显增高(P ＜0.001),集落形成百分数明显降低(P＜0.001)；pcDNA-Mda7质粒与X-射线联合应用效果明显好于单纯照射组和单纯转染组(P＜0.01).结论 PC-3细胞具有辐射抗性,pcDNA-Mda7质粒转染可以显著抑制PC-3细胞生长,pcDNA-Mda7质粒与X-射线联合应用效果好于单纯照射和单纯基因作用.

siRNA (small interfering RNA) interference represents an exciting new technology that could have therapeutic applications for the treatment of viral infections. However, a major challenge in the use of siRNA as a therapeutic agent is the development of a suitable delivery system. We demonstrated that a new non-viral transgene carrier, recombinant archaeal histone from the hyperthermophile Pyrococcus horikoshii OT3 (HPhA), can transfect short hairpin RNA (shRNA) expressing plasmids into HL-7702 cells to inhibit the expression of HCV 5'NTR and Core protein and mRNA. Plasmids Psilencirle transfected by HPhA inhibited the expression of HCV 5'-NTR and Core protein and mRNA in HL-7702 cells. The transfection efficiency of HPhA in HL-7702 cells was not affected by 10% fetal calf serum (FCS). HPhA exhibited effects of transfection without apparent toxicity, and with high affinity for DNA. This suggests that HPhA may be useful for RNAi-based gene therapy in vivo.

早在1947年,Vague[1]就提出肥胖可分为中心性肥胖(内脏性肥胖)和外周性肥胖,并指出肥胖尤其是中心性肥胖与胰岛素抵抗及代谢综合征的发生密切相关.近年来随着膳食结构和生活方式的改变及社会压力的增大,全球的肥胖率呈现出明显的上升趋势.肥胖尤其是中心性肥胖已成为威胁人类健康的重要公共卫生问题,备受大家关注.

BACKGROUND/AIMS:Increasing evidence suggests an association between elevated serum aminotransferase levels and metabolic disorders (metabolic syndrome, hyperlipidemia and diabetes mellitus). However, the significance of relatively low levels of aminotransferases in relation to metabolic disorders has not been fully investigated in the general population. We investigated the association between serum aminotransferase levels and metabolic disorders using data from a survey in Jilin Province, China. MATERIALS AND METHODS:In 2007, a prospective survey was conducted throughout Jilin, China, covering both urban and rural areas. A total of 3835 people, 18-79 years old, were undergoing real-time ultrasonography, blood tests, and interviews with a structured questionnaire. RESULTS:Serum aminotransferase levels within the normal range were associated with metabolic syndrome independent of age, occupation, cultural and educational level, income, body mass index, waist circumference, smoking, and alcohol intake. Compared with the lowest level (< 20 IU/L), the adjusted odds ratios for alanine aminotransferase levels of 20-29, 30-39, 40-49, and >50 IU/L were 1.92, 2.50, 2.97, and 3.52 in men, and 1.38, 1.54, 3.06, and 2.62 in women, respectively. Near-normal serum aminotransferase levels associated with hyperlipidemia, non-alcoholic fatty liver disease, and diabetes mellitus were also found in the study. CONCLUSIONS:Normal to near-normal serum aminotransferase levels are associated with metabolic disorders. Serum alanine aminotransferase levels of 21-25 IU/L for men and 17-22 IU/L for women are suggested as cut-off levels that detect metabolic disorders affecting the liver.

Objective To provide epidemiological data of non-infectious chronic diseases containing hypertension,diabetes mellitus(DM),dyslipidemia,alcoholic fatty liver disease(ALD),non-alcoholic fatty liver disease(NAFLD),metabolic sydrome(MS),overweight and central obesity and determine their risk factors in Dehui city in Jilin Province.Methods A total of 6 043 individuals including 11 neighborhoods and 9 villages were chosen based on cross-section study.A multivariate logistic regression was conducted between non-infectious chronic diseases and those risk factors.Results The prevalences of hypertension,DM,dyslipidemia,ALD,NAFLD,MS,overweight and central obesity were reported as 28.67%,4.82%,51.00%,3.74%,15.5%,21.54%,58.22%,and 36.67%,respectively,and the prevalence of hypertention was higher in males than that in females(P0.001),and the results were reversed in central obesity,dyslipidemia,MS and NALD(P0.05).A multivariate logistic regression analysis showed that the OR were 1.04(95%CI:1.03-1.05) for age,19.42(95%CI:11.62-32.4) for fatty liver,1.15(95%CI:1.06-1.26) for FBG,1.38(95%CI: 1.19-1.59) for hypercholesterolemia,1.32(95%CI:1.1-1.49) for hypertriglyceridemia,1.42(95%CI:1.3-1.47)for BMI,which were the main risk factors for non-infectious chronic diseases.Conclusion Non-infectious chronic diseases are very common among adult population in Dehui.As people get older the prevalence of various chronic diseases gradually increases.The occurrence and development of non-infectious chronic diseases has significant relation with life habit,dietary habit,economic level and education.

BACKGROUND:Chronic liver diseases are a major burden in China. Alanine aminotransferase (ALT) can be used as an indicator of hepatocyte damage. In this study, we determined the prevalence and etiologies of elevated ALT in an adult population in Jilin, China.METHODS:A total of 4072 individuals aged between 18 and 79 years were first interviewed, and then underwent ultrasonography and blood tests.RESULTS:The prevalence of elevated ALT was 17.53%. The most noticeable risk factor for ALT elevation was non-alcoholic fatty liver disease (NAFLD) (accounting for 10.79%), metabolic syndrome (16.25%), or both (20.31%). The development of NAFLD occurred mostly in female peasants and small businessmen with increased income, age, fasting plasma glucose, body mass index, triglyceridemia, and low-density lipoprotein and decreased education level, high-density lipoprotein. Elevated ALT frequently occurred in low education level, male peasants and small businessmen with increased income, body mass index and triglyceride who had NAFLD and/or metabolic syndrome. However, elevated ALT with infection of hepatitis B or C virus was not associated with metabolic disorders, but rather with gender, occupation and increased age.CONCLUSION:The results from the current study demonstrate that elevated ALT is fairly high in the Northeast population (17.53%) and that the cause of its elevation is mostly due to NAFLD and metabolic syndrome.

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a serious health concern in China. The goal of this cross-sectional study was to determine the prevalence of NAFLD and identify the risk factors associated with this disease in Northern China. METHODS In 2007, a total of 6063 adults from Dehui, a city in Northern China, were surveyed and demographic and social-economic characteristics, life behaviors, and medical history were recorded. Among them, 3850 subjects were randomly selected for physical examination, fasting plasma glucose (FPG) test, fasting lipid and liver function profiles, hepatitis B and C infection screening, and ultrasound examination. The frequency of NAFLD in this population was analyzed by the Chi-square test and the association of potential risk factors was analyzed by logistic regression. RESULTS The prevalence of NAFLD was 15.9% in this population and the prevalence in females was significantly higher than that in males, particularly for the elderly subgroup. Obesity, hypertension, FPG, diabetes, and metabolic syndrome (MS)-related hyperlipidemia were significantly associated with NAFLD. The data indicate that MS-related multiple risk factors synergistically increase the risk for NAFLD. CONCLUSION The prevalence of NAFLD is high in Northern China, which may be associated with the high incidence of diabetes, hypertension, and MS in this area.

Background and aim: The prevalence of the hepatitis B virus (HBV) is higher in adults than in children. We determined the seroepidemiology of HBV infection in an adult population in JiLin, China, to guide effective preventive measures.Methods: A cross-sectional serosurvey was conducted throughout JiLin, China. A total of 3833 people was selected and demographic and behavioral information gathered. Serum samples were tested for HBV markers and liver enzymes.Results: The prevalence of the hepatitis B surface antigen (HBsAg), the antibody to the hepatitis B surface antigen (anti-HBs), the hepatitis B e antigen (HBeAg), the antibody to HBeAg (anti-HBe), and the antibody to the hepatitis B core antigen (anti-HBc) were 4.38%, 35.66%, 1.38%, 6.65%, and 40.88%, respectively. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were significantly higher among HBsAg (+) than HBsAg (-) subjects. By multivariate logistic regression analysis, independent predictors for chronic HBV infection were smoking, poor sleep quality; occupation as private small-businessmen, laborers, or peasants; male gender; family history of HBV; personal history of vaccination; and older age. Independent predictors for exposure to HBV were large family size, occupation as a private small-businessman, male gender, family history of HBV, personal history of vaccination, and older age. Independent predictors for immunity by vaccination were occupation as a private small-businessman, high income, personal history of vaccination, and young age. Independent predictors for immunity by exposure were drinking, male gender, personal history of vaccination, and older age.Conclusions: The prevalence rate of HBV infection (4.38%) was lower than the previous rate of general HBV vaccination. However, 44.59% of the population remained susceptible to HBV. The prevalence of HBV infection was high in young adults, private small-businessmen, peasants, those with a family history of HBV, and males. Therefore, immunization of the non-immune population is reasonable to reduce hepatitis B transmission between adults.

BACKGROUND:Serum biochemical liver tests (LTs) (alanine aminotransferase, aspartate aminotransferase, and gamma glutamyltransferase) and platelet counts are often used to screen for chronic liver disease. We determined the prevalence and etiologies of abnormal LTs in an adult population in Jilin, China.METHODS:A total of 3791 individuals between the ages of 18 and 79 years were interviewed and then underwent ultrasonography and blood tests.RESULTS:The prevalence of abnormal LTs was 14.77% (560 out of 3791 subjects). The risk factors for abnormal LTs were non-alcoholic fatty liver disease (NAFLD) alone, which accounted for 11.61%, metabolic syndrome alone for 25%, or both for 22.14%. Abnormal LTs were more common in male than in female subjects. The development of abnormal LTs was correlated with older age males, increased daily alcohol intake, poor quality of sleep, smoking, fasting plasma glucose, body mass index, triglyceridemia, and low-density lipoprotein. Abnormal LTs in patients with metabolic syndrome and NAFLD were associated with high fasting plasma glucose, triglycerides, body mass index, low density lipoprotein, male, young age, poor sleep quality, smoking, and alcohol intake. However, abnormal LTs in patients with hepatitis B virus were associated with gender and increased age.CONCLUSIONS:The results from the current study demonstrated that the prevalence of abnormal LTs is high in the population (14.77%). Metabolic syndrome, NAFLD, and alcohol intake appear to be potentially important causes of the observed abnormal LTs.

Aim: To investigate the prevalence of obesity and associated risk factors in the Northeastern Chinese city of Dehui.Methods: A cross-sectional study involving random sampling methods generated 3598 completed questionnaires by permanent residents of Dehui. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with obesity.Results: Based on the 2000 WHO diagnostic criterion regarding populations in the Asia-Pacific region, the prevalence of obesity was 37.71% (34.77% of females; 41.11% of males). Elevated body mass index (BMI) was significantly associated with cardiovascular disease (CVD)-associated conditions (P < 0.05), and increased prevalence of abnormally high transaminase levels (P < 0.05). Binary logistic regression analysis demonstrated the following variables were associated with obesity: increased age (odds ratio [OR]: 1.01, 95% confidence interval [CI]: 1.0-1.02), high total cholesterol (TC) (OR: 1.26, 95% CI: 1.03-1.54), high triglycerides (TG) (OR: 1.38, 95% CI: 1.16-1.64), hypertension (OR: 1.62, 95% CI: 1.39-1.90), fatty liver (OR: 2.91, 95% CI: 2.41-3.49), living in an urban setting (OR: 2.84, 95% CI: 2.39-3.38), and advanced education (OR: 1.22, 95% CI: 1.06-1.40).Conclusions: Obesity is prevalent among the adult population in Northeastern China and is significantly associated with CVD risk factors such as hypertension, dyslipidemia, as well as transaminase abnormalities. (C) 2010 Elsevier Ireland Ltd. All rights reserved.