Research progress on bone metabolism and molecular mechanisms in accelerated aging SAMP6 mice / 中国药理学通报

Senile osteoporosis (SOP) is a systemic bone disease characterized by increased susceptibility to fractures. The pathogenesis of SOP is complex and not well understood. Currently, the rapid aging model mouse, senescence accelerated mouse prone 6 (SAMP6), is an ideal model for studying the mechanisms of SOP development and exploring its prevention and treatment. This model exhibits characteristics including increased bone fragility, degradation of bone microstructure, loss of bone matrix, and abnormal metabolism and dysfunction of bone cells, faithfully replicating the process of SOP occurrence and progression at both macroscopic and microscopic levels.

Effect of nerve growth factor on elderly degenerative knee osteoarthritis pain / 中国骨伤

OBJECTIVE@#To explore effect of nerve growth factor (NGF) antibody on knee osteoarthritis (KOA) pain model was evaluated by in vitro model.@*METHODS@#Thirty male SPF rats aged 28-week-old were divided into blank group (10 rats with anesthesia only). The other 20 rats were with monoiodoacetate (MIA) on the right knee joint to establish pain model of OA, and were randomly divided into control group (injected intraperitoneal injection of normal saline) and treatment group (injected anti-NGF) intraperitoneal after successful modeling, and 10 rats in each group. All rats were received retrograde injection of fluorogold (FG) into the right knee joint. Gait was assessed using catwalk gait analysis system before treatment, 1 and 2 weeks after treatment. Three weeks after treatment, right dorsal root ganglia (DRG) were excised on L4-L6 level, immunostained for calcitonin gene-related peptide (CGRP), and the number of DRGS was counted.@*RESULTS@#In terms of gait analysis using cat track system, duty cycle, swing speed and print area ratio in control and treatment group were significantly reduced compared with blank group (P<0.05). Compared with control group, duty cycle and swing speed of treatment group were significantly improved (P<0.05), and there was no significant difference in print area ratio between treatment group and blank group (P>0.05). The number of FG-labeled DRG neurons in control group was significantly higher than that in treatment group and blank group (P<0.05). The expression of CGRP in control group was up-regulated, and differences were statistically significant compared with treatment group (P<0.05).@*CONCLUSION@#Intraperitoneal injection of anti-NGF antibody inhibited gait injury and upregulation of CGRP in DRG neurons. The results suggest that anti-nerve growth factor therapy may be of value in treating knee pain. NGF may be an important target for the treatment of knee OA pain.

Entrecruzamiento del orbicular para el entropión senil mediante técnica de Martínez-Rodríguez modificada

Objetivo: Describir los resultados de la técnica de entrecruzamiento del orbicular, descrita por profesores eméritos del Pando Ferrer, en el entropión senil. Métodos: Se realizó un estudio observacional descriptivo longitudinal retrospectivo con pacientes atendidos en el Instituto Cubano de Oftalmología Ramón Pando Ferrer entre enero del 2021 a junio de 2022. La muestra estuvo constituida por pacientes operados con entropión senil con la técnica de Martínez Rodríguez modificada. Se les realizó examen ocular completo con seguimiento a las 24 h, 7 y 15 días, al mes y a los tres meses posteriores a la cirugía. Las variables utilizadas fueron edad, sexo, lateralidad, tiempo de cirugía y complicaciones. Resultados: La edad media fue de 79,26 años, con predominio del sexo masculino (69,56 %) en 23 pacientes y 26 párpados; siendo 20 casos unilaterales y 3 bilaterales. Se reportó una complicación de hipocorreción (3,84 %) y un tiempo medio de 11,9 minutos. Conclusiones: La técnica descrita es un abordaje efectivo demostrado en la baja frecuencia de complicaciones, sencillo y poco invasivo para entropión senil sin laxitud horizontal grave.

Objective: To describe the results of the orbicularis crosslinking technique, described by emeritus professors from Pando Ferrer institute, in senile entropion. Methods: A retrospective, longitudinal, descriptive and observational study was carried out with patients who received attention at Instituto Cubano de Oftalmología Ramón Pando Ferrer between January 2021 and June 2022. The sample consisted of patients with senile entropion operated on with the modified Martinez-Rodriguez technique. They underwent a complete ocular examination with follow-up at 24 hours, 7 and 15 days, one month and three months after surgery. The used variables were age, sex, laterality, surgery time and complications. Results: The mean age was 79.26 years, with a predominance of the male sex (69.56 %) in 23 patients and 26 eyelids; there were 20 unilateral cases and 3 bilateral ones. One complication of hypocorrection (3.84 %) and a mean time of 11.9 minutes were reported. Conclusions: The described technique is an effective approach for senile entropion, demonstrated according to the low frequency of complications, as well as simple and minimally invasive and without severe horizontal laxity.

Tratamiento quirúrgico del divertículo de Zenker; un caso clínico; Hospital Militar Central de La Paz (COSSMIL) gestión 2022 / Surgical treatment of Zenker's diverticulum, a Clinical Case Central Military Hospital of La Paz (COSSMIL) gestión 2022

Se presenta un caso clínico de una paciente de 66 años de edad masculino que acude a nuestro hospital (COOSMIL), después de hacer una anamnesis donde el paciente manifiestas molestias como tos, regurgitación y mal alientos (halitosis) y se le hace exámenes complementarios y se llega a un diagnóstico de divertículo faringo-esofágico o Zenker. Esta patología no es muy frecuente, pero se presenta en ancianos por una alteración anatomo-funcional que es un debilitamiento del músculo esofágico Hay tres divertículos esofágicos de los cuales el divertículo de Zenker es el más común aunque es relativamente raro que se presente, en la mayoría de las personas en edad seniles. Después de analizar el tamaño y forma del divertículo de este paciente se toma la decisión de una intervención quirúrgica el más acertado por el tamaño que mide es la diverticulectomia este tratamiento quirúrgico actualmente se continúa realizando en esta patología y con buen pronóstico de vida del paciente. Actualmente, el paciente se encuentra en buen estado salud y su recuperación es favorable desde la operación hasta el momento.

A case of a male patient of 66 years old was referred to our hospital (COSSMIL), after making an anamnesis in which the patient manifested cough, regurgitation and bad breath (halitosis). After further examination a the diagnosis is pharyngo-esophageal diverticulum or Zenker. This condition is rare, but sometimes it happens in elders due to an anatomical and functional alteration caused by is an esophagus muscle weakening. There are three esophageal diverticula in which the Zenker diverticulum is the most common but relatively rarely to occur in elder people. Before analyzing the size and shape of the diverticulum in this patient, the decision is proceed with surgery, the most recommended solution for measuring the size of the diverticulectomy. is The surgical treatment is still being applied in this pathology, with a high probability of success. Currently, the patient is in good health and the recovery from surgery is favorable so far.

Factores asociados a dermatoporosis en una muestra de pacientes geriátricos en México / Factors associated with dermatoporosis in a sample of geriatric patients in Mexico

Resumen Introducción: La dermatoporosis es un síndrome crónico de fragilidad cutánea, caracterizado por atrofia, púrpura y pseudocicatrices en piel. Objetivo: Determinar los factores asociados a dermatoporosis en una muestra de sujetos ≥ 60 años. Métodos: Estudio observacional, transversal, descriptivo y analítico de sujetos ≥ 60 años a quienes se realizó historia clínica, exploración física y aplicación de un autocuestionario diagnóstico de dermatoporosis. Para determinar los factores asociados se realizó análisis de regresión logística multivariado. Resultados: En 315 sujetos, la prevalencia de dermatoporosis fue de 29 %; 70 % fue del sexo femenino. Los factores asociados fueron edad > 75 años (p = 0.001), exposición solar prolongada (p = 0.002), ingesta de anticoagulantes/antiplaquetarios (p = 0.004), esteroides orales (p = 0.03) y enfermedad renal crónica (p = 0.03); así como, edad materna > 40 años en el último parto (p = 0.02), lactancia > 7 meses por embarazo y lactancia acumulada > 18 meses (p = 0.01). Se relacionaron con su ausencia, edad < 20 años en el primer embarazo y menopausia después de los 45 años. La correlación entre la autovaloración y el diagnóstico clínico fue muy alta (0.95, p < 0.001). Conclusiones: Los factores de riesgo asociados a dermatoporosis fueron similares a los previamente reportados.

Abstract Introduction: Dermatoporosis is a chronic cutaneous fragility syndrome, characterized by skin atrophy, purpura and pseudo-cicatrices. Objective: To determine factors associated with dermatoporosis in a sample of subjects aged ≥ 60 years. Methods: Observational, cross-sectional, descriptive, analytical study of subjects aged ≥ 60 years who underwent history taking, physical examination and application of a self-administered dermatoporosis diagnostic questionnaire. To determine the associated factors, a multivariate logistic regression analysis was used. Results: In 315 evaluated subjects, the prevalence of dermatoporosis was 29%; 70% were females. Associated risk factors were age > 75 years (p = 0.001), prolonged sun exposure (p = 0.002), use of anticoagulants/antiplatelet medications (p = 0.004), oral steroids (p = 0.03) and chronic kidney disease (p = 0.03); as well maternal age > 40 years at last pregnancy (p = 0.02), breastfeeding for > 7 months per pregnancy and > 18 cumulative months (p = 0.01). Age < 20 years at first pregnancy and menopause after 45 years were related to dermatoporosis absence. The correlation between self-assessment and clinical diagnosis was considerably high (0.95, p < 0.001). Conclusions: The risk factors associated with dermatoporosis were similar to those previously reported.

Multiple cerebral infarction complicated with vascular Parkinsonism on cognitive function in patients / 公共卫生与预防医学

Objective To analyze the influence of patients with multiple cerebral infarction complicated with vascular Parkinsonism (VaP) on cognitive function, and to provide a theoretical basis for the diagnosis and treatment of patients with multiple cerebral infarction complicated with VaP. Methods A toatl of 206 patients with multiple cerebral infarction admitted to Ningde municipal hospital of ningde normal university from January 2020 to January 2022 were selected and divided into VaP group (n=58) and control group (n=148) according to whether they were complicated with VaP. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of patients. The scale included 8 cognitive domains including attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation and orientation. Pearson was used to analyze the correlation between VaP and MoCA score in patients with multiple cerebral infarction. Age, sex, years of education, white matter disease, diabetes mellitus, coronary heart disease and other vascular risk factors were compared between the two groups. The independent risk factors for VaP in multiple cerebral infarction were analyzed by multiple linear regression. Results MoCA score in VaP group was significantly lower than that in control group (P<0.05). In terms of each item, scores of attention and concentration, memory, language and computation in VaP group were significantly lower than those in control group (P<0.05). Pearson correlation analysis showed that attention and concentration, memory, language and computational scores were correlated with VaP in patients with multiple cerebral infarction (r=-0.475, -0.314 , -0.302 , -0.389, P<0.05). There were statistically significant differences between the two groups in white matter lesions, lesion sites in left hemisphere and frontal lobe, diabetes mellitus and carotid artery plaque (P<0.05).White matter lesions (OR=2.571), diabetes mellitus (OR=2.369) and lesion location in the left hemisphere (OR=2.958) were independent risk factors for VaP in patients with multiple cerebral infarction (P<0.05). Conclusion The risk of VaP in multiple cerebral infarction is high, which is related to the cognitive function of patients. Early intervention such as brain function training should be given to patients with white matter lesions, diabetes and lesions in the left hemisphere. , can significantly improve patients' cognitive function and reduce the occurrence of VaP.

A Meta-analysis of the association between adipokines and bone nutrition of senile osteoporosis in China / 中华临床营养杂志

Objective:Through meta-analysis, the association of three common adipokines (leptin, adiponectin, and chemerin) with bone nutrition of senile osteoporosis (SOP) in China was systematically evaluated.Methods:CNKI, CBM, VIP, Wanfang, PubMed, Web of Science, Embase, Cochrane Library, and other databases were searched for articles published from the establishment of the database to July 30, 2022. After literature screening, data extraction, and quality evaluation of the included studies were independently conducted by two researchers, a meta-analysis was performed using RevMan5.4 and Stata17.0 softwares.Results:A total of 13 studies in the Chinese population were included, including 897 patients with SOP and 673 elderly with normal bone mineral density . The results of the meta-analysis showed that compared with the control group, the serum leptin levels were significantly lower ( MD -2.64, 95% CI -4.04 to -1.23, P < 0.001), chemerin levels were significantly higher ( MD 25.23, 95% CI 14.57 to 35.90, P < 0.001), and adiponectin levels were not significantly different ( MD -0.55, 95% CI -2.26 to 1.17, P > 0.05) in SOP patients. After subgroup analysis according to the measurement method, leptin levels remained lower in SOP patients than in the control group. Conclusions:Compared with the control group, leptin levels were lower and chemerin levels were higher in SOP patients. Therefore, dysregulation of adipokines may play an important role in the occurrence and development of SOP, and regulation of adipokine levels and functions may play a role in the treatment of SOP and the improvement of bone nutrition as a nutritional intervention.

Discussion on medication law of Shao Nianfang in the treatment of kidney deficiency and bone marrow loss in senile dementia based on ancient and modern medical case cloud platform / 国际中医中药杂志

Objective:To discuss the medication law in prescriptions of Professor Shao Nianfang in the treatment of kidney deficiency and bone marrow loss in senile dementia based on data mining.Methods:Medical cases of kidney deficiency and bone marrow loss in senile dementia in the Geriatric Hospital of Shandong University of Traditional Chinese Medicine from 1st Jan. 2014 to 31st Oct, 2019 were collected. Through hospital electronic medical records system prescription statistics, using ancient and modern medical case cloud platform (V1.2.4), medication frequency, property ans taste, efficacy analysis, correlation rule analysis, clustering analysis and complex network analysis were performed.Results:Totally 110 cases were included in medical cases, involving 238 kinds of Chinese materia medica. The top 10 Chinese materia medica with use frequency were Poria, Acori Tatarinowii Rhizoma, Corni Fructus, Dioscoreae Rhizoma, Rehmanniae Radix Praeparata, Alpiniae Oxyphyllae Fructus, Rehmanniae Radix, Astragali Radix, Chuanxiong Rhizoma, Atractylodis Macrocephalae Rhizoma; the properties were mainly mild, warm slight cold, and cold; the tastes were mainly sweet, bitter, pungent, and light; the meridians were mainly spleen, liver, lung and kidney meridians; the efficacy was clearing dampness and promoting diuresis, clearing heat and promoting blood circulation, calming mind, clearing heat and detoxification, reducing dampness and promote appetizing, tonifying spleen; the association analysis found 15 groups of drug combinations used more than 25 times, they were: Corni Fructus and Poria, Corni Fructus and Dioscoreae Rhizoma, Dioscoreae Rhizoma and Corni Fructus, Rehmanniae Radix Praeparata and Corni Fructus, Dioscoreae Rhizoma and Poria, Astragali Radix and Poria, Alismatis Rhizoma and Poria, Moutan Cortex and Poria, Rehmanniae Radix Praeparata and Poria, Rehmanniae Radix and Poria, Polygalae Radix and Acori Tatarinowii Rhizoma, Moutan Cortex and Corni Fructus, Moutan Cortex and Dioscoreae Rhizoma, Alismatis Rhizoma and Corni Fructus, Alismatis Rhizoma and Dioscoreae Rhizoma; clustering analysis identified four groups of new prescriptions, the first group: Poria, Rehmanniae Radix, Rehmanniae Radix Praeparata, Alismatis Rhizoma, Moutan Cortex, Corni Fructus, Dioscoreae Rhizoma; the second group: Acori Tatarinowii Rhizoma, Cistanches Herba, Morindae Officinalis Radix; the third group: Alpiniae Oxyphyllae Fructus, Chuanxiong Rhizoma, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle; the fourth group: Atractylodis Macrocephalae Rhizoma, Codonopsis Radix, Astragali Radix, Angelicae Sinensis Radix; the results of complex network analysis showed that the core prescription was modified Liuwei Dihuang Pills. Conclusion:This study found that in view of kidney deficiency and bone marrow loss in senile dementia, Professor Shao pays attention to strengthening the healthy qi, and focuses on tonifying deficiency, taking into account the methods of clearing dampness, clearing heat, detoxification, removing blood stasis and restoring consciousness. The four new prescriptions found in the study can provide a reference for modified medication for syndrome differentiation.

Clinical value of comprehensive intervention based on VTE risk score for venous thrombosis in elderly type 2 diabetes inpatients / 上海预防医学

ObjectiveTo explore the effect of targeted intervention measures based on risk score of venous thromboembolism （VTE）， on the prevention of senile type 2 diabetes inpatients， as well as their influence on the occurrence of venous thromboembolism. MethodsA total of 134 elderly patients with type 2 diabetes mellitus who were hospitalized in geriatrics department of Peking university third hospital during June 1， 2018 to September 30， 2018 were selected as the research subjects. All the patients were divided into control group and observation group according to random number table method， with 67 patients in each group. Patients in the control group were treated with conventional intervention methods， and patients in the observation group were treated with targeted intervention measures based on VTE risk score. After one month of intervention， the Padua score， blood glucose level and coagulation indexes of the two groups were compared. The incidence of thrombosis during the intervention period was also recorded. ResultsThe Padua score in observation group （2.09±2.17） points was significantly lower than that （3.19±2.37） points in control group （P<0.05）. The indexes of fasting blood glucose， 2h postprandial blood glucose and HbA1c in observation group were significantly lower than those in control group （P<0.05）. The fibrinogen， D-dimer， activated partial thromboplastin time and prothrombin time in observation group were significantly lower than those in control group （P<0.05）. The incidence of DVT， PVT， lower limb swelling， pain and abnormal skin color in the observation group were 4.00%， 2.00%， 2.00%， 2.00%， and 0， respectively， and in the control group were 12.00%， 10.00%， 10.00%， 12.00%， and 8.00%， respectively. The incidence of adverse events in observation group was significantly lower than that in control group （P<0.05）. ConclusionTargeted intervention based on VTE risk score can significantly reduce the risk of VTE occurrence， improve blood clotting function and blood glucose level in elderly patients with type 2 diabetes mellitus. This nursing measure has important clinical application value.

Trend and gender difference of mortality rate of senile dementia： based on the method of annual percent change / 上海预防医学

ObjectiveTo investigate the characteristics of gender difference and the trend of the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018， and to provide the basis for formulating relative intervention measures before and after senile dementia from an public-health view. MethodsBased on the collected data of death registration， focused on the senile dementia disease codes F03，G30.0，G30.1，G30.8，G30.9 according to The International Classification of Diseases 10th revision （ICD-10）. We analyzed the characteristics of gender difference in the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018. According to ASR， we calculated the standardized mortality rate of senile dementia， and used the chi-square test to compare the difference between the gender mortality rates. The trend and the turning point of the mortality rate of senile dementia were determined by linear regression analysis by Join-point. ResultsThe crude mortality rate of senile dementia in the registered population in Shanghai from year 2002 to 2018 was 5.46/105， 3.50/105 in males and 7.43/105 in females. The standardized mortality rate of senile dementia was 2.61/105， 1.67/105 in males and 3.56/105 in females. The trend of the standardized mortality rate of senile dementia in 17 years decreased ［APC=-5.5（-6.5，-4.5）%，P<0.01］. The trend of the standardized mortality rate of senile dementia decreased in both males ［APC=-4.9（-6.2，-3.6）%，P<0.01］ and females ［APC=-5.9（-6.9，-4.9）%，P<0.01］. The trend of the gender difference decreased ［APC=-6.8（-8.2，-5.3）%，P<0.01］. The mortality rate of senile dementia was higher in females than in males ［（χ2=33.63，P<0.01）］. ConclusionThe mortality rate of senile dementia in females is higher than in males in Shanghai， though the trend of the gender difference decreased. This gender difference is worth of attention.

Research progress on the relationship between senile osteoporosis and sex hormones / 公共卫生与预防医学

Senile osteoporosis is closely related to the level of sex hormones. Estrogen and androgen play important physiological roles in senile men and women with osteoporosis. Androgen can stimulate the proliferation and differentiation of osteoblasts to promote bone formation and improve bone mineral density and bone mass. Estrogen can bind to estrogen receptors to directly regulate bone metabolism and reduce bone resorption. This article reviews the relationship between senile osteoporosis and sex hormones.

Association of Serum 8-isoprostaglandin F2? Levels with Glycemic Control in Type 2 Diabetes Patients with Senile Cataract

Background : Lipid Peroxidation (LPO) plays a major initiative factor of cataractogenesis in both age-related or senile cataract and Diabetic cataract. Recently, 8-isoprostaglandin F2? (8-iso-PGF2?) is a reliable biomarker of in-vivo LPO and used as potential indicator of oxidative stress. However, serum 8-iso-PGF2? concentration and its association with glycemic control (HbA1c) in the pathogenesis of diabetic cataract subjects are still unknown. Objectives : The present study was designed to estimate 8-iso-PGF2? and antioxidant enzymes levels in serum of Type 2 Diabetes Mellitus patients with senile cataract compared to healthy individuals without cataract as control. To assess the magnitude of the association between 8-iso-PGF2? and glycemic status in diabetic cataract. Materials and Methods : 60 Diabetic Senile Cataracts (DSC) and 60 healthy individuals without cataract in the age group between 45-75 years of both genders. 8-iso-PGF2?, Superoxide Dismutase [Cu-Zn] (SOD3) and Catalase (CAT) concentration were estimated in serum by ELISA method. Results : The mean concentration of 8-iso-PGF2? was significantly increased (541.6±142.7 pg/ml, p<0.001) and mean concentration of SOD3 (102.1±32.8 ng/ml, p=0.007) and Catalase (1005±274.5 IU/ml, p<0.001) were significantly decreased in serum of diabetic senile cataract when compared to healthy individuals without cataract (control). A negative correlation between serum 8-iso-PGF2? and SOD3 and positive correlation between serum 8- iso-PGF2? and fasting blood glucose were observed in Diabetic Senile Cataracts. Conclusion : The present findings indicate that increased 8-iso-PGF2? is associated with oxidative stress which plays a significant role in the pathogenesis of cataract in diabetic patients

Principles of diagnosis and treatment of elderly patients / 中华老年医学杂志

The elderly are a special group, with their unique pathophysiology and disease characteristics.The measures and goals of diagnosis and treatment for the elderly are different from those for children, young and middle-aged people.Taking into consideration of the national and international literature, the insight from our long-term clinical practice and in-depth reflections, the authors have written this article as a reference for our colleagues in geriatric care.

The influence path of stigma on the time of healthcare-seeking decision in caregivers of elderly patients with dementia and humanistic care strategies / 中国实用护理杂志

Objective:To clarify the influence and influence paths of stigma on the time of the healthcare-seeking decision in caregivers of elderly patients with dementia, and to provide a theoretical basis for the construction of corresponding humanistic care strategies.Methods:A total of 176 caregivers of elderly patients with dementia who visited the Affiliated Hospital of Xuzhou Medical University and Xuzhou Oriental People ′s Hospital from February 2021 to February 2022 were selected as the study subjects. The General Information Questionnaire, self-designed Scale of Stigma for Caregivers of Senile dementia patients, Multidimensional Scale of Perceived Social Support, self-designed Elderly Dementia Caregivers′ Perceived Barriers Scale for Healthcare-seeking Decision, and self-designed Scale of the Intention to Seek Healthcare for caregivers of senile dementia patients were used in the survey. AMOS 20.0 was used to establish a structural equation model for path analysis. Results:The higher the stigma of caregivers, the longer the time of the healthcare-seeking decision ( β=0.05, P<0.05). Social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare were the mediating variables of caregivers ′ stigma affecting the time of the healthcare-seeking decision, with a total effect of -0.04, 0.14, and 0.36, respectively, and all P<0.05. Conclusions:The stigma in caregivers of senile dementia patients is an important factor affecting the time of the healthcare-seeking decision. By improving mediating factors including social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare, the implementations of targeted humanistic care strategies are expected to help shorten the time of the healthcare-seeking decision.

Correlation of TNFAIP3 gene polymorphism with osteoporotic fractures and bone metabolism in elderly patients / 中华内分泌外科杂志

Objective:To investigate the correlation between TNFAIP3 gene polymorphism and osteoporotic fractures in the elderly and bone metabolism indexes.Methods:A total of 115 patients with senile osteoporotic fractures admitted to Peace Hospital Affiliated to Shanxi Changzhi Medical College from Jan. 2019 to Jun. 2021 were enrolled as the observation group, and 120 patients with senile osteoporotic fractures matched with gender, age and body mass index of the observation group were selected as the control group. The levels of blood calcium, blood phosphorus, alkaline phosphatase, 25-hydroxyvitamin D and other bone metabolism indexes of all subjects were recorded. The genotypes of rs10499194 and rs13207033 in TNFAIP3 gene were analyzed by capillary electrophoresis and fragment analysis (SNaPshot) . The mRNA relative expression level of TNFAIP3 gene in peripheral blood of all subjects was determined by quantitative real-time fluorescence quantitative polymerase chain reaction.Results:There were statistically significant differences in genotype distribution and gene frequency of RS10499194 and RS13207033 between the observation group and the control group ( P<0.05) . For rs10499194, CT genotype carriers had a significantly higher risk of fracture than wild-type CC genotype carriers [OR=3.253 (1.223-8.652) , P=0.014]. The dominant model was also statistically significant ( P=0.003) . For rs13207033, GA carriers had a significantly higher risk of fracture than wild-type GG carriers [OR=3.775 (1.192-11.952) , P= 0.016]. The dominant model was statistically significant ( P=0.009) . The blood calcium level in AA+GA group was significantly higher than that in GG group at rs13207033 site ( P=0.006) . The mRNA expression level of TNFAIP3 gene in the observation group was 1.41±0.09, which was significantly lower than that in the observation group (2.07±0.12, t=6.69, P<0.001) . TNFAIP3 mRNA expression level of rs10499194 site TT+CT group was 1.35±0.11, significantly lower than CC group 1.43±0.13 ( t=2.82, P=0.007) . Conclusion:The polymorphism of TN-FAIP3 gene is related to the occurrence of osteoporotic fractures and bone metabolism, and may affect the gene expression level.

Clinical Efficacy and Bone Turnover Markers of Buzhong Yiqitang in Treatment of Senile Osteoporotic Vertebral Compression Fracture After Operation Based on ''Spleen Governing Muscle'' / 中国实验方剂学杂志

ObjectiveTo study the effect on quality of life and the bone turnover markers of Buzhong Yiqitang in the treatment of senile osteoporotic vertebral compression fracture （OVCF， syndrome of Qi deficiency in spleen and stomach） after operation based on ''spleen governing muscle''. MethodA total of 135 senile patients with OVCF treated by percutaneous kyphoplasty in Rizhao Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were enrolled in this study. They were randomly assigned to two groups on the basis of block randomization at a ratio of 2∶1 （90 cases in the observation group and 45 cases in the control group）. Both groups were administrated with calcitriol capsules （0.5 μg·d-1） and caltrate D （1 200 mg·d-1） for basic treatment of osteoporosis. The observation group was additionally treated with Buzhong Yiqitang. Bone mineral density （BMD）， procollagen type Ⅰ N-terminal propeptide （PINP）， osteocalcin （OST）， β cross-linked C-telopeptide of type 1 collagen （β-CTx）， appendicular skeletal muscle mass index （ASMI）， and quadriceps muscle strength were compared between the two groups before and 6， 12 months after treatment. Additionally， traditional Chinese medicine （TCM） symptom score and visual analogue score （VAS） before and 3， 6 months after treatment， as well as quality of life questionnaire of the European Foundation for osteoporosis （QUALEFFO） score before and 3， 6， 12 months after treatment， were compared between the two groups. ResultA total of 85 patients in the observation group and 41 patients in the control group were followed up. The general curative effect of the observation group was better than that of the control group （χ2=10.503， P<0.05）. Specifically， the observation group had higher PINP， BMD， ASMI， and quadriceps muscle strength but lower β-CTx， TCM symptom score， VAS， and QUALEFFO score than the control group （P<0.05， P<0.01）. No adverse reactions related to Buzhong Yiqitang were observed. ConclusionBuzhong Yiqitang can regulate bone metabolism indexes， promote osteogenesis， increase bone density， enhance skeleton appendiculare and quadriceps muscle strength， relieve clinical symptoms， and improve quality of life in patients with senile OVCF （syndrome of Qi deficiency in spleen and stomach）， being worthy of promotion in clinical application.

Bazi Bushen Capsules on Anti-aging： A Review / 中国实验方剂学杂志

The decline of body function and senile diseases caused by aging seriously affect human health and life span， which is an important topic in the field of life science. Bazi Bushen capsules is a representative Chinese patent medicine for tonifying essence， invigorating Qi and anti-aging， guided by Qiluo doctrine， and essence， Qi and spirit theory. Previous pharmacological and clinical studies have confirmed that this preparation has the comprehensive advantages of anti-aging， and prevention and treatment of aging-related diseases. Among them， pharmacological studies showed that Bazi Bushen capsules had the effect of improving the appearance status of mice， improving the level of sex hormones， inhibiting the formation of atherosclerosis， improving cardiac function， improving learning and memory cognitive ability， improving neurological function， improving osteoporosis and muscle function， improving sperm count and quality. The mechanism was related to the up-regulation of the recombinant sirtuin （SIRT6） level， down-regulation of the levels of aging-related proteins p53 and p16， up-regulation of telomerase reverse transcriptase level， and alleviation of inflammation and oxidative response. Clinical studies have proved that it can improve the symptoms of patients with kidney essence deficiency， improve exercise ability， and improve the sexual function of impotence patients. Anti-aging research of Bazi Bushen capsules based on Qiluo doctrine fully embodies the new mode of academic innovation and transformation of traditional Chinese medicine （TCM） with the combination of "theory-new drug-experiment-clinic"， which has made a demonstration for the anti-aging research of TCM.

Research on Anti-aging Guided by Qiluo Doctrine / 中国实验方剂学杂志

Along with increasing degree of population aging globally， senility， good health and long life have become the focus of the world. Guided by Qiluo doctrine， an essence， Qi and spirit theory is proposed as below， essence is the origin of life， Qi is the impetus of life and spirit is the embodiment of life. Based on holistic view of kidney deficiency involving the five internal organs and injuries of the five internal organs definitely affecting the kidney， a mechanism of aging is proposed as below， deficiency of kidney essence is the foundation of aging， deficiency of promordial Qi is the key of aging and physical and spiritual loss is the manifestation of aging. It provides a theoretical guidance for anti-aging study of rejuvenating the elderly and making the strong person stronger. By virtue of the experiences in kidney-tonifying medication accumulated for more than two thousand years， Bazi Bushen capsules has been developed， which has anti-aging efficacy， including tonifying kidney， replenishing essence， coordinating Yin and Yang， supplementing primordial Qi and nourishing body and spirit. Experimental researches have demonstrated that Bazi Bushen capsules can improve overall aging and systemic aging， as well as prevent and treat aging related diseases. Preliminary clinical studies demonstrate that this capsules can enhance athletic ability and improve sexual function， and is expected to become a representative Chinese patent medicine of anti-aging. This paper addresses aging and anti-aging on the basis of Qiluo doctrine， in the hope of helping prevention and treatment of aging related diseases.

Risk factors and drug resistance of pathogenic bacteria in senile stroke-associated pneumonia / 公共卫生与预防医学

Objective To analyze the risk factors and pathogen drug resistance of senile stroke-associated pneumonia (SAP), and to provide references for early clinical intervention. Methods A total of 859 elderly patients with cerebral stroke admitted to our hospital from June 2018 to June 2020 were selected and divided into the study group (SAP, n=375) and the control group (no SAP, n=484) according to the occurrence of stroke associated pneumonia. Clinical data of age, gender, and other complications of the two groups were analyzed. The sputum culture and drug sensitivity test of senile SAP patients were analyzed. Results A total of 313 pathogens were detected in 375 SAP patients, including 211 strains of gram-negative bacteria (67.41%), mainly consisting of 92 Acinetobacter baumannii (29.39%), 54 Pseudomonas aeruginosa (17.25%), and 42 Klebsiella pneumoniae (13.42%), and 73 strains (23.32%) of gram-positive bacteria, mainly 62 strains of Staphylococcus aureus (19.81%). In addition, there were 29 strains of fungi (9.27%). Pseudomonas aeruginosa was highly sensitive to piperacillin/tazobactam and ceftazidime. Acinetobacter baumannii and Klebsiella pneumoniae were highly sensitive to imipenem, meropenem, and cefoperazone sodium and sulbactam sodium. Staphylococcus aureus and Enterococcus were highly sensitive to teicolanin, linezolid and vancomycin. The proportion of patients aged ≥80 years old, mechanical ventilation, bed rest and use of prophylactic antibiotics in the experimental group was significantly higher than that in the control group (P<0.05). Logistic regression analysis showed that age ≥80 years, mechanical ventilation, hypoproteinemia and use of prophylactic antibiotics were independent risk factors for SAP (P<0.05). Conclusion The main pathogens of stroke-associated pneumonia in the elderly are Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. It is necessary to rationally choose antibiotics according to the results of drug sensitivity. The risk factors are patients' age ≥ 80 years old, mechanical ventilation, and bed rest. Clinicians should attach great importance to the prevention of stroke-related pneumonia in the elderly.

Predictive value of low-density lipoprotein cholesterol in cardiovascular events in elderly diabetic patients / 公共卫生与预防医学

Objective To analyze the predictive value of low-density lipoprotein cholesterol (LDL-c) on cardiovascular events in elderly patients with diabetes, and to provide theoretical guidance for the prevention of cardiovascular disease in elderly patients with diabetes. Methods A total of 180 elderly patients with diabetes treated at the Department of Cardiovascular Medicine, Hubei Jianghan Oilfield General Hospital from June 2019 to June 2020 were selected. According to the LDL-c level, they were divided into low-risk group (LDL-c 0.05). The serum TG, TC, and LDL-c levels, and Gensini scores in the high-risk group were significantly higher than those in the low-risk group, and the serum LDL-c level in the high-risk group was significantly lower than that in the low-risk group (P2=7.500, P<0.05). Spearman correlation analysis showed that LDL-C was positively correlated with the incidence of MACE (r=0.781, P<0.05). Multivariate logistic regression analysis showed that LDL-c≥2.6mmol/L was an independent risk factor for cardiovascular disease in elderly diabetic patients (P<0.05). The area under ROC curve for LDL-c to predict cardiovascular events in DM patients was 0.814 (95%CI:0.767~0.912), and the sensitivity and specificity were 78.40% and 84.80%, respectively. Conclusion LDL-c level is significantly increased in elderly patients with diabetes, and LDL-c≥2.6 mmol/L is of certain value in predicting cardiovascular events in patients with diabetes.