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Frailty is one of the most common clinical geriatric syndromes and has become a hot topic in the geriatric field in recent years.Frailty can confer an increased risk of adverse outcomes such as falls, hospitalization and even death.Therefore, timely diagnosis and intervention of frailty is of great practical significance for improving the health status of the elderly and alleviating the burden on the social and medical service systems.This article reviews mechanisms, types and effects of exercise intervention measures and summarizes research progress on exercise intervention in the elderly with frailty, in order to provide a reference for future research on exercise intervention for frailty.
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Objective To explore the possible factors of early postoperative fluid balance and the influence of early postoperative fluid balance on the prognosis of patients undergoing cardiopulmonary bypass. Methods A retrospective study was conducted on the clinical data of 180 adult patients undergoing cardiopulmonary bypass from January 2012 to December 2015.All the patients were from Sun Yat-sen Memorial Hospital, Sun Yat-Sen University. The data were input and analyzed by SPSS 17.0 software. Results The early postoperative fluid balance of cardiovascular surgery with cardiopulmonary bypass was (540.94 ± 135.86) ml. The value of the early postoperative fluid balance (the difference of the total input amount and the total output amount/body quality) in predicting the major clinical outcome was analyzed by ROC curve. The area under the ROC curve from fluid balance was 0.850 (95%CI 0.736-0.965, P<0.01) and it had the sensitivity of 80.0%, and the specificity was 84.6%. The result showed that the cut off values had a good prediction ability for outcome. The cut off values determined by the biggest Youden index were 28.63 ml/kg, indicated that patients may had better outcome when they had the fluid balance of 28.63 ml/kg. The level of early postoperative fluid balance of patients undergoing cardiopulmonary bypass was correlated with mechanical ventilation time, ICU length of stay, higher risk of acute kidney injury, mixed venous oxygen saturation and clinical outcome (P<0.05). Multivariate analysis indicated that European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ), other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow were independently associated with postoperative fluid balance of patients undergoing cardiopulmonary bypass. Conclusions Early postoperative fluid balance has a good prediction ability for prognosis of patients undergoing cardiopulmonary bypass. Compared with patients having lower level of fluid balance, the patients with a higher level would be more likely to have longer mechanical ventilation time, longer ICU length of stay, higher risk of acute kidney injury and lower level of mixed venous oxygen saturation. By analysis of ROC curves, the cut-off value for early postoperative fluid balance is 28.63 ml/kg, worse prognosis may be predicted if fluid balance is above 28.63 ml/kg. EuroSCORE Ⅱ, other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow are independently associated with the postoperative fluid balance of patients undergoing cardiopulmonary bypass.
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After the connotation of the standard system for digitalization of ancient medical documents was analyzed, its construction principles were elaborated with measures proposed for how to construct it.
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Objective To screen the potential biomarkers in plasma of rats with acute paraquat (PQ) poisoning using gas chromatography-mass spectrometry (GC-MS) based metabonomics technology,and to provide concrete evidence for early diagnosis.Methods Eight Sprague-Dawley (SD) rats were randomly divided into PQ poisoning group (intragastricly administrated with PQ solution 100 mg/kg) and control group (intragastricly administrated with the same volume of normal saline) according to the random number table,with 4 rats in each group.The general situation of rats was observed at 2,24 and 48 hours after administration.The blood of eye sockets was collected,the endogenous small molecule metabolites in plasma were determined with GC-MS method,and metabolic profile analysis and random forest analysis were performed to filter the potential biomarkers.Results ① The rats in PQ poisoning group gradually appeared lack movement,tachypnea,abdominal seizure and other symptoms of poisoning.In control group,the vital signs were stable.② The metabolites in plasma of rat were analyzed with GC-MS analysis,and the diagrammatic figure was plot as combined with principal component analysis (PCA) and partial least squares-discriminated analysis (PLS-DA) model,which showed that the distribution of plasma metabolism in PQ poisoning group was more diffuse but in the control group was more intensive,indicating that the metabolic patterns in two groups were different.From 2 hours after PQ administration,the metabolic trajectory in PQ poisoning group was significantly deflected compared with that of the control group,which was similar to control group until 48 hours,indicating that the metabolites in plasma of rat showed obvious difference in the early period.Five kinds of potential biomarkers with large weights were selected by random forest method which were serine,L-asparagine,hexadecanoic acid,octadecanoic acid,and arachidonic acid,the retention time was 15.259,24.345,33.334,37.695,and 40.254 minutes,respectively.The levels of serine,L-asparagine,arachidonic acid in PQ poisoning group were significantly higher than those of the control group,peaked at 48,48 and 24 hours,respectively (40.884-5.38 vs.28.85±2.32,6.61±1.31 vs.0.76±0.65,14.21±4.28 vs.4.42±1.19,all P ＜ 0.01),and the levels of hexadecanoic acid and octadecanoic acid were significantly lowered,reached tough at 48 hours (39.09 ± 10.23 vs.83.99 ± 20.49,44.03 ± 3.60 vs.140.76 ± 73.91,P ＜ 0.05 and P ＜ 0.01).The changes in these biomarkers were related to the toxicity of PQ,indicating that PQ could interfere the energy and lipid metabolism in rats.Conclusion Combine with the metabonomics analysis,screened plasma serine,L-asparagine,arachidonic acid content in PQ poisoning rats increased significantly,and hexadecanoic acid and octadecanoic acid content decreased significantly,which can preliminary diagnose acute PQ poisoning with animal general performance.
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Objective:To investigate the influence of miR-7 knock down on the development of CD 4+SP cells in the thymus in mice,and preliminary explore its possible mechanism.Methods:The changes of volume ,weight and total cell counts of thymus in miR-7 knock down (miR-7KD) mice were observed compared with Wild-type(WT)mice;the pathological changes of thymus were observed by HE staining.FACS analysis was performed on the proportion ,as well as the expression level of CD44 and CD62L,of thymus CD4+single positive (SP) cells.Meanwhile,the proliferation percentage of CD4+SP cells was measured by Ki-67 staining.The apoptosis percentage of CD4+SP cells was analyzed by FACS.The changes on the transduction of ERK 1/2 pathways were determined by Western blot.Results:Compared with WT mice ,the size,weight and total cell number of thymus were marked reduced in miR-7KD mice( P<0.05 );moreover ,pathological change also was presented.The proportion and total cell number of thymus CD 4+SP cells were marked decreased ( P<0.05 ).Furthermore ,the expression level of CD 44 and proliferation percentage ,as well as apoptosis percentage ,of CD4+SP cells were obviously increased (P<0.05),however,the expression level of CD62L of CD4+SP cells were decreased (P<0.05). Finally,the level of total ERK1/2 and phosphor-ERK1/2 was decreased obviously ( P<0.05 ).Conclusion: miR-7 knock down can affect the development of CD 4+SP cells in the thymus , which might be closely related to the cell activation state and altered the transduction of ERK1/2 pathways.
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Objective To investigate the factors influencing the daily life information searching behaviors in elderly people receiving different old-age services.Methods The factors influencing the daily life information searching behaviors in 1178 elderly people with their age >60 years receiving different old-age services in the central region of China were investigated with questionnaire and assessed according to self-designed daily life information search-ing scale .Results The total score of daily life information searching behaviors in elderly people receiving home-, community-and institution-based old-age service was 62 .63 ±13 .13 , 65 .16 ±13 .37 ,and 57 .84 ±11 .98 , respec-tively.Age, health state, education level, body factors, insufficient equipments, and information search ability were the factors influencing the daily life information searching behaviors in elderly people .Conclusion Old-age service should be strengthened and the daily life information searching ability of elderly people should be improved according to the factors that influence their daily life information searching behaviors .
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Objective To observe the expressions of c-Ski in renal tissue of diabetic nephropathy rats, and discuss its significance. Methods Wistar male rats were randomly assigned to 3 groups: Control group, diabetic group and treatment group. Rats were killed at the 16th week after experiment. Histopathologic changes,in renal tissue were observed and immunohistochemistry was performed to investigate the expression of TGF-β1, α-SMA and c-Ski. Results The expression of c-Ski had a negative correlation with TGF-β1 and α-SMA. Compared to diabetic group, the expression of c-Ski was significantly increased in treatment group. Conclusion c-Ski may be a protective factor of tu-bular epithelial-myofibroblast transformation.
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Objective To study the effect of rhein on the process of tubular epithelial-mesenchymat transformation in kidney of diabetic rats. Methods Wistar male rats were randomly assigned to 3 groups: Control group (N group, n=12),diabetic group(D group, n=12), rhein treatment group(R group, n=12).The rats of rhein treatment group were treated with daily intragastric administration of periment. The excretion of urinary protein and serum creatine were measured. Histological changes of renal tissue were observed by HE and MASSON stain. Immunohistochemistry was performed to investigate the expression of E-cadherin, α-SMA,FN and TGF-β1 in kidney. Results Compared with the control group, the tubulointerstitial injury and the accumulation of extraeellular matrix protein in diabetic models were obvious(P＜0.01).Compared with the control group, the expression of E-cadherin was decreased significantly and the expression of α-SMA,FN and TGF-β1 was increased significantly in diabetic group. E-cadherin was negatively correlated with TGF-β1(rs=-0.60,P＜0.05),α-SMA and FN was positively correlated with TGF-β1(rs=0.88,P＜0.05;rs:0.91,P＜0.01).In comparison with diabetic group,rhein could up-regulate the expression of E-cad and down-regulate the expression of α-SMA and FN in renal tubular epithelial cells(P＜0.01).Conclusion Rhein could protect kidney by ameliorating interstitial fibrosis in diabetic rats. The mechanism may be depend on down-regulating the expression of TGF-β1 and suppressing tubular epithelial-mesenchymal transformation.
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Objective To explore the correlation between HLA-A, B alleles polymorphism and hemorrhagic fever with renal syndrome (HFRS) among Han nationality in Zunyi area. Methods Using group study, HLA-A, B genotypes were conducted in 100 HFRS cases and 100 controls among Han nationality in Zunyi area with polymerase chain reaction-sequence specific primer (PCR-SSP), gene frequency (GF) and relative risk (RR) were compared and calculated. Results The frequencies of HLA-A * 31 and HLA-B * 58 alleles in HFRS cases (GF=4%,12.5%) were strikingly higher than that in the healthy controls (X2=6.380, 7.792, P<0.05;RR=18.47,2.91). The frequencies of HLA-B * 40 alleles in HFRS cases (GF=11%) were strikingly higher than that in the healthy controls (X2=6.095,P<0.01, RR=O.47). Conclusion HLA-A * 31, B * 58 genes are positively related to HFRS of Han nationality in Zunyi area, HLA-B * 40 gene is negatively related to HFRS of Han nationality in Zunyi area.
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Objective:To explore the association between HLA-DR,DQ allele polymorphisms and onset of epidemic hemorrhagic fever(EHF)among Han Nationality in Zunyi area.Methods:Using group study,HLA-DR and DQ genotyping was conducted in 100 EHF cases and 100 controls among Han Nationality in Zunyi area with polymerase chain reaction-sequence specific primer(PCR-SSP),GF(gene frequency)and RR(relative risk)were calculated and compared.Results:The frequency of HLA-DRB1 16 in patients with EHF was higher than in the control group(RR=3.58,?2=4.916,P=0.0266
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Detection of EHF antibody Is usually performed by using patient'sSerum.This artical reports the urine IgG antibody assay with RFC-SpA andIFA in 111 EHF patients.The positive rate was 94.6%,being nearly thesame as serum material(95.5%).And also,the urine samples can be simplycollected.
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Objective:To observe the level of serm soluble E-selectin(sE-selectin) in patients with pulmonary tuberculosis and to study the clinical significance of it. Methods: the sE-selectin levels of the serum were measured by enzyme-linked immunoadsorbent assay(EILSA) in 40 untreated patients, 20 patients who had been treated for 2 months with pulmonary tuberculosis and 20 normal individuals.Results: In compared with controls, the average serum levels of sE-selectin were much higher in patients with pulmonary tuberculosis( P
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Objective:To investigate frequencies and polymorphism of HLA-DRB1 and DQB1 allele in the Hans of Zunyi area.Methods:Polymerase chain reaction-sequence specific primers(PCR-SSP) were used to type HLA-DRB1 and DQB1 genes of 200 unrelated healthy Han individuals in Zunyi area.Results:13 HLA-DRB1 and 7 HLA-DQB1 alleles were obtained at low resolution level in all subjects.The allele DRB1*09,DRB1*08 and DQB1*05 were showed high distributing frequencies;The allele DRB1*10 and DQB1*04 were scarcely found with low distributing frequencies.Comparied with Northern and Southern Han people,it would seem that Han people in Zunyi are more closely related to the Southern ones.The allele B*07 was scarcely found in the Southern Han with a high distributing frequency(GF=2.0%).Conclusion:HLA-DRB1 and DQB1 of Han people in Zunyi have plenty of polymorphisms.They seem to distribute in line with the Southern Han's characteristics but have their own territory feature with a high B*07 frequency.