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Sarcopenia is an age-related syndrome characterized by progressive and systemic loss of skeletal muscle mass and strength with age.Sarcopenia in the elderly not only leads to falls, fractures, disability, and reduced exercise ability, but also increases their risk of death and financial burden.At present, a number of professional organizations and institutions have published consensus on the assessment and diagnosis of sarcopenia, but the included parameters are not completely consistent.In this paper, the diagnostic criteria and related parameters of each consensus are reviewed.
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Objective:To develop a set of indexes for the assessment of healthy older adults in China, in order to provide a reference and basis for developing aging-related national policies, standardizing and guiding health management services for the elderly.Methods:A set of indexes for the assessment of healthy older adults in China was established based on a literature review, expert discussions, 2 rounds of Delphi surveys, expert consultations and a cross-sectional study assessing the indexes.Results:The positive coefficients for 2 rounds of expert consultations were 86.25%(69/80)and 94.52%(69/73), respectively.All surveyed experts(100%)specialized in the area of geriatric health and came from 22 provincial-level administrative regions in China.In the two rounds of consultations, the familiarity degree coefficients were 0.706-0.915 and 0.835-0.922, and the authority coefficients were 0.762-0.921 and 0.863-0.932, respectively.The mean importance scores of each index were 6.10-9.74 scores and 7.87-9.56 scores, with perfect score rates of 43%-99% and 75%-99%, respectively.The mean coefficients of variation(CV)were 0.19±0.05(0.07-0.34)and 0.16±0.03(0.10-0.21), respectively.The set of indexes for the assessment of healthy older Chinese adults covered multi-dimensions including physical health, mental health and social health, with 3 primary indexes, 11 secondary indexes and 17 tertiary indexes.Conclusions:The construction process of the set of indexes for the assessment of healthy Chinese adults was scientific and rigorous, and the panelists had a high level of agreement, strong authority and active participation.The set of indexes has comprehensive coverage and an inclusive framework, and indexes at each level are scientific and feasible.It can serve as a reference for the comprehensive assessment of health status of the elderly and for aging-related government policy formulation in the future.
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Objective:To explore the clinical efficacy of double opposing rhomboid flap in repairing facial skin defects.Methods:From January 2020 to December 2020, 30 cases of facial skin lesions were removed in the Department of Plastic and Aesthetic Surgery, the Affiliated Hospital of Qingdao University, including 12 males and 18 females, aged 14-65 years, with an average age of 34.2 years. The diameter of the facial skin defect wound was 0.5-2.0 cm. The patients with facial skin defect were repaired with double opposing rhomboid flap. All patients were followed up for 3-12 months.Results:The incisions of 30 patients were healed in one stage, and double opposing rhomboid flaps survived. Following-up for 3 to 12 months showed that the operation area was flat, the incision scar was not obvious, the texture and color of the operation area and the surrounding skin matched well, the surrounding organs were not deformed, the lesions were not recurrent, and the cosmetic effect was satisfactory.Conclusions:The double opposing rhomboid flap is an effective method to repair quasi-circular facial skin defects, which is worthy of clinical application.
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Objective:To analyze the process of Chinese expert consensus on the core information on prevention of sarcopenia in the elderly(2021)in China, so as to realize the early diagnosis and treatment of sarcopenia and to improve the quality of life in the elderly.Methods:The index system framework was established by literature review and expert questionnaire discussion, and Delphi expert consultation method was adopted to construct the index system.Results:A total of 109 experts(128 person-times)in Geriatrics from various fields participated in Delphi expert consultation.Positive coefficient for four rounds of expert consultation were 88.9%, 100.0%, 100.0% and 100.0% respectively, with expert authority factors being concentrated on 0.78~0.90.Through 4 rounds of Delphi expert surveys, the core information index system for sarcopenia prevention in the elderly has been definitive: Chinese Expert Consensus(2021)consists of nine indicators including "enhancing public scientific awareness of myosis, and so on."Conclusions:The core information index system for sarcopenia prevention in the elderly has high levels of overall convergence, comprehensive coverage, strong authority, stability, comprehensiveness and popularity.
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Objective:To comprehensively evaluate the utilization of some essential medicines among elderly people in clinic settings in China, in order to provide a reference for the selection of fully reimbursed medicines for the elderly.Methods:Expert consultations were conducted to evaluate the utilization of 58 essential medicines related to eight major therapeutic areas, including neurology, psychiatry, cardiovascular diseases, respiratory diseases, among elderly people.The evaluation indexes included safety, efficacy, compliance by medical staff, compliance by patients, clinical value, and pharmaceutical economics.Results:Except for psychiatry, authority coefficients for drugs related to the other therapeutic areas were greater than 0.7, indicating that experts were familiar with the indications of the medications.According to the comprehensive evaluation scores, 10 medicines, i.e., nitroglycerin, metoprolol tartrate, isosorbide dinitrate, omeprazole, metformin, amlodipine, aspirin, acarbose, valsartan, and clopidogrel, could be considered as the first choices for guaranteed essential drugs for the elderly.Meanwhile, another 10 medicines, including nifedipine, estazolam, tamsulosin, simvastatin, alfacalcidol, enalapril, bisoprolol, beclomethasone dipropionate, ipratropium, and salbutamol, could be considered as the second choices for guaranteed essential drugs for elderly people.Conclusions:The first choices recommended by experts as guaranteed essential drugs for the elderly are mainly cardiovascular, endocrine and respiratory medicines, in line with the disease spectrum of the elderly.The selection of essential medications with full cost reimbursement for elderly patients should be those frequently used and with a burden of high medicine costs.
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Objective@#To develop a core information index system of disability for the elderly, which is suitable for the elderly in China and has educational and guiding significance and universal application value.@*Methods@#The index system framework was established through an extensive literature review and expert discussions, and the index system was constructed by the Delphi expert consultation method.@*Results@#A total of 74 experts (84 person-times)from various fields participated in the Delphi expert consultations.The positive coefficients of experts for the five rounds of expert consultations were 94.55%, 100.00%, 100.00%, 100.00% and 100.00%, respectively.The authoritative coefficients of experts ranged from 0.75 to 0.90.Based on the five rounds of Delphi expert surveys, the core information index system of disability for the elderly was composed of 16 indicators including health literacy of the elderly, nutritional status, musculoskeletal function, vaccination, prevention of falls, attention to mental health, social function, etc.@*Conclusions@#The core information index system of disability for the elderly is comprehensive, covering all components considered essential by a consensus from experts in various fields, and it is authoritative, extendable, scientific, influential, stable and popular.
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Objective To develop a core information index system of disability for the elderly,which is suitable for the elderly in China and has educational and guiding significance and universal application value.Methods The index system framework was established through an extensive literature review and expert discussions,and the index system was constructed by the Delphi expert consultation method.Results A total of 74 experts (84 person-times)from various fields participated in the Delphi expert consultations.The positive coefficients of experts for the five rounds of expert consultations were 94.55 ％,100.00 ％,100.00 ％,100.00 ％ and 100.00 ％,respectively.The authoritative coefficients of experts ranged from 0.75 to 0.90.Based on the five rounds of Delphi expert surveys,the core information index system of disability for the elderly was composed of 16 indicators including health literacy of the elderly,nutritional status,musculoskeletal function,vaccination,prevention of falls,attention to mental health,social function,etc.Conclusions The core information index system of disability for the elderly is comprehensive,covering all components considered essential by a consensus from experts in various fields,and it is authoritative,extendable,scientific,influential,stable and popular.
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Objective To investigate the types of common chronic diseases and common drugs in the elderly visiting primary medical institutions in China.Methods Cluster sampling was adopted in eight provinces/cities/autonomous region of Zhejiang,Jilin,Henan,Shanghai,Chongqing,Gansu,Guangxi and Jiangsu.Sampling sites were selected and information was collected through the online reporting system of common diseases and drug costs of the elderly in primary hospitals at all levels in China.On these grounds,the basic situation of primary medical institutions,the common chronic diseases and common drugs for people aged 65 years and above were investigated.Results Primary hypertension(65.7％ or 46/70)and arthropathy(10.0％ or 7/70)were the most common chronic diseases in the elderly visiting primary medical institutions.The consultation rate of primary hypertension was highest both in rural areas(58.3％,i.e.the ratio of 21 over 36 primary medical institutions)and in urban areas(73.5％,i.e.the ratio of 25 over 34 primary medical institutions).The primary medical institutions with consultation rates of hypercholesterolemia/hyperlipidemia (x2 =5.137,P=0.023),diabetes(x2 =3.868,P =0.049)and dyspepsia(Fisher's exact test,P =0.026)as the top 3 chronic diseases were more often seen in urban areas than in rural areas,while the primary medical institutions with consultation rates of cerebrovascular diseases as the top 3 chronic diseases were more often seen in the rural areas than in urban areas(x2=9.974,P =0.002).More primary medical institutions with consultation rates of benign prostatic hyperplasia and primary osteoporosis as the top 10 chronic diseases were found in urban areas than in rural areas(x2 =4.054 and 3.861,P =0.044 and 0.049,respectively),while more primary medical institutions with consultation rates of heart failure as the top 10 chronic diseases were found in rural areas than in urban areas(x2 =3.865,P =0.049).Aspirin,nifedipine and simvastatin one by one were most commonly used in people aged 65 years and over in primary medical institutions.Conclusions Primary hypertension is the most common chronic disease among the elderly visiting primary medical institutions in both rural and urban.Common chronic diseases in primary medical institutions are different between the urban and rural areas.Regional differences and urban-rural differences should be taken into account in drug preparation.There are some irregularities in the use of drugs and insufficient stocks of essential drugs in basic-level medical institutions.
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[ ABSTRACT] AIM:To investigate the effect of triptolide on the inhibition of microglial activation in 1-methyl-4-phenyl pyridinium ( MPP+)-induced hemiparkinson disease rats.METHODS:The rat model of Parkinson disease was es-tablished by intranigral injection of MPP +.The rats were randomly divided into sham group, MPP+group, triptolide group and vehicle group.The survival of dopaminergic neurons was detected by the immunofluorescence of tyrosine hydroxylase ( TH) in the substantia nigra ( SN) .The activation of microglia was determined by immunofluorescence of OX-42 ( micro-glia marker) in the SN.The expression of chemokine receptor CX3CR1 in SN was measured by Western blotting.RE-SULTS:Intranigral injection of MPP+increased the fluorescence intensity of the microglial marker, and promoted DA neu-ron degenerative death.Immunohistological analysis showed that the OX-42 density was decreased (P<0.01) and tyrosine hydroxylase (TH) positive neurons were increased in the triptolide group (P<0.01).The expression of CX3CR1 was lower in triptolide group than that in model group (P<0.05).CONCLUSION:Triptolide may improve PA neurons func-tion in MPP+-induced rats through inhibiting CX3CR1 expression and microglial activation.
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Objective:To investigate the effect of scutellarin on P-gp protein expression and activity in Caco-2 cells. Methods:Scutellarin(25,50 and 100 μmol·L-1 )was incubated with Caco-2 cells respectively for 24 h,48 h and 72 h. The expression of P-gp was determined by western blot assay and the activity of P-gp was determined by Rhodamine-123 assay. Results:P-gp protein ex-pression levels were significantly increased by scutelarin. After the incubation for 24 h with scutellarin,P-gp protein expression was up-regulated 2. 34-,2. 65-and 2. 00-fold in Caco-2 cells. After the incubation with scutellarin for 48 h,P-gp protein expression was up-regulated 2. 70-,4. 66-and 3. 13-fold. After the incubation with scutellarin for 72 h,P-gp protein expression was up-regulated 2. 82-, 2. 62-and 1. 84-fold. The intracellular accumulation of rhodamine-123 was significantly decreased by scutellarin,indicating that the ef-flux transport activity of P-gp was increased by scutellarin in Caco-2 cells. Conclusion:Scutellarin can significantly up-regulate P-gp protein expression and increase the efflux transport activity of P-gp in Caco-2 cells.
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Objective To investigate the neuroprotective effect of Dengzhan Shengmai capsule (DZSM) in rat cerebral ischemia-reperfusion injury and to explore the mechanism. Methods Rats were divided into Sham group, MCAO group, DZSM group, carbenoxolone (CBX) group and DZSM + CBX group. Each group was assessed for neurological function , infarct volume and the expression of Caspase-3 48 h after reperfusion. Connexin 43 (Cx43) expression of MCAO group was detected 3, 12, 24, 48 h after reperfusion. Results There were lower neurological deficit scores , infarct volume and the expression of Caspase-3 in DZSM , CBX and DZSM + CBX group 48 h after reperfusion when compared with those in MCAO group (P < 0.05) but Cx43 expression level in each group increased after reperfusion at each time point (P < 0.05). Expression of Cx43 was lower in DZSM, CBX and DZSM + CBX group than that in MCAO group (P < 0.05). Lower expression of Cx43 was also seen in CBX and DZSM + CBX group when compared with that in DZSM group (P < 0.05). Conclusion DZSM capsule can improve neurological function , reduce infarct volume and inhibit the expression of Caspase-3. The mechanism may be related to its inhibition of Cx43 expression.
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AIM:To investigate the integrative treatment of both coenzyme Q 10 ( CoQ10 ) and minocycline in the rats intranigrally intoxicated with 1-methyl-4-phenylpyridinium ( MPP+) .METHODS:The rat model of Parkinson disease ( PD) was established by intranigral microinjection of MPP +.The degree of microglial activation was measured by immuno-fluorescent density of OX-42 ( a microglia marker ) in the substantia nigra ( SN) .The number of viable dopaminergic neurons was determined by counting the tyrosine hydroxylase ( TH) positive neurons in the SN .The behavioral performances were re-vealed with the number of apomorphine-induced rotations , score of forelimb akinesia and vibrissae-elicited forelimb placing a-symmetry.RESULTS:Pretreatment with CoQ10 or intracerebroventricular (icv) posttreatment with minocycline alone pro-vided partial attenuation against MPP +-induced locomotor defects .Integrative therapy provided enhanced beneficial effects , and resulted in a significant attenuation of locomotor disability than any single therapy (all P<0.01).The results of immu-nohistological analysis showed that the TH positive neurons were maximally protected by integrative therapy compared with minocycline group and CoQ 10 group (P<0.01) .CONCLUSION:The integrative therapy of CoQ 10 combined with minocy-cline may offer additional therapeutic benefit to MPP +-induced hemiparkinson rat model .Such neuroprotective strategy of tar-geting different aspect of the neurodegenerative phenotypes may highlight a new therapeutic strategy for future management of PD.
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Objective To discuss the feasibility and accuracy of dual-source CT ( DSCT) in the evaluation of aortic stenosis ( AS) with transthoracic echocardiography ( TTE) as reference.Methods A total of 53 patients who underwent both DSCT and TTE were prospectively evaluated.All of them were assessed by TTE for aortic stenosis.Maximum aortic valve area ( AVA) in systolic phase was measured with DSCT , and was compared to that index obtained from the continuity equation on TTE.The severity of AS was graded as mild , moderate , or severe according to the AVA.Linear regression analysis and Bland-Altman plots were used to compare the AVA measured by using CT and TTE.Agreement on semi-quantitative grades of AS severity between the two methods was tested by using Kappa statistics.Results The mean AVA using DSCT was (1.45 ±0.35 ) cm2 compared to the mean AVA of ( 1.33 ±0.36 ) cm2 using TTE, with a significant correlation between them (r=0.92,P<0.01).Bland-Altman analysis demonstrated good inter-modality consistency between DSCT and TTE.However , DSCT demonstrated a slight overestimation of the AVA compared to TTE.As identified by TTE, there were 53 patients with AS, 13 with mild AS, 21 with moderate AS , and 19 with severe AS.In 3 patients DSCT showed no AS , TTE detected mild AS.In 6 cases, TTE had graded the stenosis as moderate , but the stenosis degree was graded as mild using DSCT.Kappa analysis showed a good agreement between the two methods on semi -quantitative grades of aortic stenosis severity (Kappa=0.75,P<0.01).Conclusion AVA measurements using DSCT is feasible and reasonably accurate for those patients with moderate to severe aortic stenosis.