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Thirty-day outcomes of in-hospital multi-vessel versus culpritonly revascularization strategy for ST-segment elevation myocardial infarction with multivessel coronary disease

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Journal of Geriatric Cardiology 2023年第7期20卷 485-494页

作者： Yu-Xi LI Bei-Ning WANG Fang-Fang FAN Yan ZHANG Jie JIANG Jian-Ping LI Ya-Ling HAN Yong Huo CCC investigators Department of Cardiology Peking University First HospitalBeijingChina Cardiovascular Research Institute and Department of Cardiology General Hospital of Northern Theater CommandShenyangLiaoningChina 不详

BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery ***,only a few single-center retrospective studies were performed on small Chinese *** study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese *** From the Improving care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were *** 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were *** primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and *** Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or *** analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.

关键词： infarction coronary myocardial

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Early successes and late failures in the prevention of post endoscopic retrograde cholangiopancreatography

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World Journal of Gastroenterology 2007年第26期13卷 3567-3574页

作者： John G Lieb ii Peter V Draganov Gastroenterology Fellow Division of GastroenterologyDepartment of Internal MedicineUniversity of Florida FL 32610-0214United States Associate Professor of Medicine Division of GastroenterologyUniversity of Florida FL 32610-0214United States

Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The only way to prevent this complication is to avoid an ERCP all together. Because of the risks involved, a careful consideration should be given to the indication for ERCP and the potential risk/benefit ratio of the test. Once a decision to perform an ERCP is made, the procedure should be carried out with meticulous care by an experienced endoscopist, and with a minimum of pancreatic duct opacification. Several pharmacologic agents have been tested, but to date the most important method of reducing post ERCP pancreatitis is the placement of pancreatic stent. Pancreatic stents should be placed in all patients at high risk of this complication such as those undergoing pancreatic sphincterotomy, pancreatic duct manipulation and intervention, and patients with suspected sphincter of Oddi dysfunction. Pancreatic stents should be also considered in patients requiring precut sphincterotomy to gain biliary access.

关键词： Post endoscopic retrograde cholangiopancre-atography pancreatitits Somatostatin Gabexate IL-10 Pancreatic stents Aspirating catheter Sphincter of Oddidysfunction

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Delayed gastric emptying following pancreaticoduodenectomy:Incidence,risk factors,and healthcare utilization

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World Journal of Gastrointestinal Surgery 2017年第3期9卷 73-81页

作者： Somala Mohammed George Van Buren ii Amy Mc Elhany Eric J Silberfein William E Fisher Elkins Pancreas Center Michael E DeBakey Department of SurgeryBaylor College of MedicineHoustonTX 77030United States

AIM To characterize incidence and risk factors for delayed gastric emptying(DGE) following pancreaticoduodenectomy and examine its implications on healthcare utilization. METHODS A prospectively-maintained database was reviewed. DGE was classified using International Study Group of Pancreatic Surgery criteria. Patients who developed DGE and those who did not were compared. RESULTS Two hundred and seventy-six patients underwent pancreaticoduodenectomy(PD)(> 80% pyloruspreserving, antecolic-reconstruction). DGE developed in 49 patients(17.8%): 5.1% grade B, 3.6% grade C. Demographic, clinical, and operative variables were similar between patients with DGE and those without. DGE patients were more likely to present multiplecomplications(32.6% vs 4.4%, ≥ 3 complications, P care upon discharge(24.5% vs 6.6%, P care utilization. Patients with POPF and IAA were at risk for DGE. Anticipating DGE can help individualize care and allocate resources to high-risk patients.

关键词： Delayed gastric emptying Pancreaticoduodenectomy Post-operative pancreatic fistula

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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA Department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in ***:Using data from the Improving care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;P70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention Contraindication

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Delivery room resuscitation intensity and associated neonatal outcomes of 24^(+0)-31^(+6) weeks'preterm infants in China:a retrospective cross-sectional study

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World Journal of Pediatrics 2024年第1期20卷 64-72页

作者： Si-Lu Wang Chun Chen Xin-Yue Gu Zhao-Qing Yin Le Su Si-Yuan Jiang Yun Cao Li-Zhong Du Jian-Hua Sun Jiang-Qin Liu Chuan-Zhong Yang Department of Neonatology Shanghai Key Laboratory of Maternal Fetal MedicineShanghai Institute of Maternal-Fetal Medicine and Gynecologic OncologyShanghai First Maternity and Infant HospitalSchool of MedicineTongji UniversityNo.2699Gaoke Western RoadPudong DistrictShanghai 201204China Department of Neonatology Affiliated Shenzhen Maternity and Child Healthcare HospitalSouthern Medical UniversityNo.2004Hongli RoadFutian DistrictShenzhen 518028China NHC Key Laboratory of Neonatal Diseases Fudan UniversityChildren's Hospital of Fudan UniversityShanghaiChina Department of Neonatology People's Hospital of DehongKunming Medical UniversityDehongChina Department of Neonatology Children's Hospital of Fudan UniversityShanghaiChina Department of Neonatology Children's HospitalZhejiang University School of MedicineHangzhouChina Department of Neonatology Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional *** source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 *** infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic *** Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the *** maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal *** strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity *** Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in *** is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.

关键词： Cardiopulmonary resuscitation Delivery room Endotracheal intubation Neonatal resuscitation Preterm

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Chinese Stroke Center Alliance:a national effort to improve healthcare quality for acute stroke and transient ischaemic attack:rationale,design and preliminary findings

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Stroke & Vascular Neurology 2018年第4期3卷 256-262页

作者： Yongjun Wang Zixiao Li Yilong Wang Xingquan Zhao Liping Liu Xin Yang Caiyun Wang Hongqiu Gu Fuying Zhang Chunjuan Wang Ying Xian David Z Wang Qiang Dong Anding Xu Jizong Zhao Chinese Stroke Center Alliance investigators China National Clinical Research Center for Neurological Diseases BeijingChina Tiantan Clinical Trial and Research Center for Stroke Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina Vascular Neurology Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina Center for Stroke Beijing Institute for Brain DisordersBeijingChina Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina Neuro-intensive care Unit Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina Office of Chinese Stroke Center Alliance Chinese Stroke AssociationBeijingChina Department of Neurology Duke University Medical CenterDurhamNorth CarolinaUSA INI Stroke Network OSF Healthcare SystemUniversity of Illinois College of MedicinePeoriaIllinoisUSA Department of Neurology Shanghai Huashan HospitalFudan UniversityShanghaiChina Department of Neurology The First Affiliated Hospital of Jinan UniversityGuangzhouChina Department of Neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijingChina 不详

Background In June 2015,the Chinese Stroke Association(CSA)initiated the Chinese Stroke Center Alliance(CSCA)to establish the national hospital-based stroke care quality assessment and improvement *** article outlines its objectives,operational structure,patient population,quality improvement(QI)intervention tools,data elements,data collection methodology and current patient and hospital *** The CSCA is a national,hospital-based,multicentre,voluntary,multifaceted intervention and continuous QI *** multifaceted intervention includes stroke centre development,written care protocols,workshops and a monitoring/feedback system of evidencebased performance *** data coordinating centre of the CSCA resides at the China National Clinical Research Center for Neurological Diseases,Beijing Tiantan *** As of July 2017,1576 hospitals in China have contributed detailed clinical information to serve as a benchmark for the stroke care quality of 433264 patients with acute stroke/transient ischaemic attacks(TIA),including 352572(81.38%)acute ischaemic stroke,30362(7.01%)TIA,42080(9.71%)spontaneous intracranial haemorrhage,5505(1.27%)subarachnoid haemorrhage and 2745(0.63%)not specified *** The CSCA programme is designed to establish a continuous national stroke registry and help healthcare providers develop stroke centres and treat patients in a consistent manner in accordance with accepted national guidelines and,ultimately,improve patient *** supports the CSA mission to reduce stroke burden in China.

关键词： centre Alliance transient

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2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment

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Chinese Medical Journal 2022年第24期135卷 2899-2910页

作者： Liya Zhou Hong Lu Zhiqiang Song Bin Lyu Ye Chen Jiyao Wang Jun Xia Zhan Zhao on behalf of Helicobacter Pylori Study Group of Chinese Society of Gastroenterology Department of Gastroenterology Peking University Third HospitalBeijing 100191China Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouZhejiang 310018China Department of Gastroenterology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China Department of Gastroenterology Fudan University Affiliated Zhongshan HospitalShanghai 200032China Nottingham Ningbo GRADE Center Nottingham China Health InstituteUniversity of Nottingham Ningbo ChinaNingboZhejiang 315100China Academic Unit of Lifespan and Population Health School of MedicineThe University of NottinghamNottinghamUK Systematic Review Solutions Ltd Shanghai 201403China 不详

Background:Helicobacter pylori(***)infection is an infectious disease with a prevalence rate of up to 50%*** can cause indigestion,gastritis,peptic ulcer,and gastric *** eradication treatment can effectively control disease progression and reduce the risk of the above ***,the escalating trend of antibiotic resistance presents a global challenge for *** *** aim to provide guidance on pharmacological treatment of *** ***:This clinical practice guideline is developed following the World Health Organization’s recommended process,adopting Grading of Recommendations Assessment,Development and Evaluation in assessing evidence quality,and utilizing Evidence to Decision framework to formulate clinical recommendations,minimizing bias and increasing transparency of the clinical practice guideline development *** used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and The Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)as reporting and conduct guides to ensure the guideline’s completeness and ***:Though decreasing in developed countries,the prevalence of *** remains high in developing countries,causing a major public health *** clinical practice guideline contains 12 recommendations concerning pharmacological treatment for *** *** them,it is worth highlighting that bismuth preparations are inexpensive,safe,and effective,consequently making bismuth quadruple therapy a preferred choice for initial and rescue *** empirical treatment,high-dose dual therapy is equally effective compared with bismuth quadruple ***:The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’values and preferences,resource use,feasibility,and *** are generalizable to resource limited settings with similar antibiotic resistance pattern as

关键词： Helicobacter pylori Peptic ulcer Guideline Pharmacological treatment

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In-hospital outcomes of anemic patients with acute coronary syndrome receiving ticagrelor versus clopidogrel: Results of the Chinese Cardiovascular care Improvement (CCC)-Acute Coronary Syndrome Project

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中华医学杂志(英文版) 2024年第20期137卷 2489页

作者： Zhang Zhiqiang Wang Yasong Wang Jun Cao Xiaofan Qiu Miaohan Tian Xiaoxiang Han Yaling Wang Xiaozeng National Key Laboratory of Frigid Zone Cardiovascular Disease Cardiovascular Research Institute and Department of Cardiology General Hospital of Northern Theater Command Shenyang Liaoning China The General Hospital of Northern Theater Command Training Base for Graduate China Medical University Shenyang Liaoning China

In individuals with acute coronary syndrome (ACS), bleeding incidents during hospitalization not only greatly increase the risk of in-hospital death but also increase the risk of long-term mortality and major adverse cardiovascular events.[4] There are presently no particular guidelines for early antiplatelet treatment in anemic individuals with ACS receiving PCI.[...]the aim of our study was to assess the in-hospital effectiveness and safety of ticagrelor and clopidogrel in anemic ACS patients undergoing PCI.To enhance the standard of treatment for individuals with ACS, the American Heart Association (AHA) and the Chinese Society of Cardiology (CSC) collaborated on the Improving care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) project.[6] According to the findings of the Platelet Inhibition and Patient Outcomes (PLATO) study, compared with clopidogrel treatment, ticagrelor treatment significantly decreased the risk of MI, stroke, and vascular death without increasing the total rate of major bleeding.

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Are EPB41 and alpha-synuclein diagnostic biomarkers of sport-related concussion?Findings from the NCAA and Department of Defense care Consortium

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Journal of Sport and Health Science 2023年第3期12卷 379-387页

作者： Rany Vorn Christina Devoto Timothy B.Meier Chen Lai Sijung Yun Steven P.Broglio Sara Mithani Thomas W.McAllister Christopher C.Giza Hyung-Suk Kim Daniel Huber Jaroslaw Harezlak Kenneth L.Cameron Gerald McGinty Jonathan Jackson Kevin M.Guskiewicz Jason P.Mihalik Alison Brooks Stefan Duma Steven Rowson Lindsay D.Nelson Paul Pasquina Michael A.McCrea Jessica M.Gill the care Consortium investigators Johns Hopkins School of Nursing and Medicine BaltimoreMD 21205USA National Institutes of Health BethesdaMD 20892USA Department of Neurosurgery Medical College of WisconsinMilwaukeeWI 53226USA Predictiv care Inc.Mountain ViewCA 94086USA Michigan Concussion Center University of MichiganAnn ArborMI 48109USA Department of Psychiatry Indiana University School of MedicineIndianapolisIN 46202USA Departments of Pediatrics and Neurosurgery University of California at Los Angeles(UCLA)Los AngelesCA 90024USA Department of Epidemiology and Biostatistics School of Public Health–Bloomington Indiana UniversityBloomingtonIN 47405USA John A.Feagin Sports Medicine Fellowship Keller Army Community HospitalWest PointNY 10996USA United States Air Force Academy Colorado SpringsCO 80840USA Mathew Gfeller Center Department of Exercise and Sport ScienceUniversity of North Carolina at Chapel HillChapel HillNC 27514USA Department of Orthopedics Division of Sports MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI 53705USA Department of Biomedical Engineering and Mechanics Virginia TechBlacksburgVA 24061USA Center for Neuroscience&Regenerative Medicine Uniformed Services UniversityBethesdaMD 20814USA 不详 Current affiliation:School of Nursing University of Texas Health Science Center San AntonioSan AntonioTX 78229USA

Background:Current protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or ***,more accurate diagnostic markers are needed for sport-related ***:This was a multicenter,prospective,case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association-Department of Defense Concussion Assessment,Research,and Education Consortium conducted between 2015 and *** blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute *** with concussion were divided into 6 h post-injury(0-6 h post-injury)and after 6 h postinjury(7-48 h post-injury)*** applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305proteins in plasma samples from athletes with and without sport-related ***:A total of 140 athletes with concussion(79.3%males;aged 18.71±1.10 years,mean±SD)and 21 non-concussed athletes(76.2%males;19.14±1.10 years)were included in this *** identified 338 plasma proteins that significantly differed in abundance(319 upregulated and 19 downregulated)in concussed athletes compared to non-concussed *** top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve(AUC)of 0.954(95%confidence interval:0.922-0.986).Specifically,after 6 h of injury,the individual AUC of plasma erythrocyte membrane protein band 4.1(EPB41)and alpha-synuclein(SNCA)were 0.956 and 0.875,*** combination of EPB41 and SNCA provided the best AUC(1.000),which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of ***:Our data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combina

关键词： Biomarkers College athletes Concussion Mild traumatic brain injury Sport injury

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Reference ranges and age-related changes of peripheral blood lymphocyte subsets in Chinese healthy adults

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Science China(Life Sciences) 2009年第7期52卷 643-650页

作者： JIAO Yang1,QIU ZhiFeng1,XIE Jing1,LI DongJing2 & LI TaiSheng1 1 Department of Infectious Disease,Peking Union Medical College Hospital,Peking Union Medical College & Chinese Academy of Medical Sciences,Beijing,China 2 Department of Special care Unit,Peking Union Medical College Hospital,Peking Union Medical College & Chinese Academy of Medical Sciences,Beijing,China Department of Infectious Disease Peking Union Medical College Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China Department of Special care Unit Peking Union Medical College Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China

This study was performed to build region-specific reference ranges of peripheral blood lymphocyte subsets for Chinese healthy adults from the young to the elderly and analyze the trends of changes in lymphocyte subsets for evaluating the impact of age on the values.151 healthy adults aged 19-86 were recruited based on the SENIEUR *** sets of reference ranges were finally built applicable for the healthy young(19-44 years),middle-aged(45-64 years) and elder adults(≥65).Comparisons in parameters among the three cohorts showed that a statistically significant increase in CD16CD56+ NK cell was observed between the middle-aged and elder cohorts,whereas for the majority of the parameters,a significant decline was observed between the young and the middle-aged *** results showed that inverse correlations were observed between the age and CD19+ B,CD3+ T,CD3+CD4+ T,CD4+CD45RA+CD62L+ nave T cell and CD4+CD28+/CD4+,while the positive one was identified between the age and the NK *** significant changes of the most of immune parameters provided evidence for ***,T cell activation markers of CD8+CD38+ and CD8+HLA-DR+ showed reverse trends of association with age,which provides a clue for further researches on the mechanisms underlying the paradoxical clinical presentation of the elder patients.

关键词： lymphocyte subsets age reference range immunosenescence

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