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This study aimed to investigate the effect of curcumin (Cur) against human cytomegalovirus (HCMV) in vitro. Human embryonic lung fibroblasts were cultured in vitro. The tetrazolium salt (MTS) method was used to detect the effects of Cur on cell viability. The cells were divided into control group, HCMV group, HCMV + (PFA) group and HCMV + Cur group in this study. The cytopathic effect (CPE) of each group was observed by plaque test, then the copy number of HCMV DNA in each group was detected by quantitative polymerase chain reaction (qPCR), and the expression of HCMV proteins in different sequence was detected by Western blot. The results showed that when the concentration of Cur was not higher than 15 μmol/L, there was no significant change in cell growth and viability in the Cur group compared with the control group (P>0.05). After the cells were infected by HCMV for 5 d, the cells began to show CPE, and the number of plaques increased with time. Pretreatment with Cur significantly reduced CPE in a dose-dependent manner. After the cells were infected by HCMV, the DNA copy number and protein expression gradually increased in a time-dependent manner. Pretreatment with Cur significantly inhibited HCMV DNA copies and downregulate HCMV protein expression levels in a concentration-dependent manner, and the difference was statistically significant (P<0.05). In conclusion, Cur may exert anti-HCMV activity by inhibiting the replication of HCMV DNA and down-regulating the expression levels of different sequence proteins of HCMV. This study provides a new experimental basis for the development of anti-HCMV infectious drugs.
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Humanos , Curcumina/uso terapêutico , Citomegalovirus/genética , Infecções por Citomegalovirus/tratamento farmacológico , Placa AteroscleróticaRESUMO
Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.
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Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.
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Objective To translate the 3-minute diagnostic confusion assessment method(3D-CAM)into Chinese,to revise it,and to test its reliability and validity in elderly patients.Methods We translated and culturally adapted 3D-CAM into Chinese.The sample was formed by 230 elderly patients over 65 years of age.We tested inter-assessors reliability and criterion validity (diagnostic validity)and then computed the sensitivity,specificity,positive predictive value,and negative predictive value of the Chinese version of 3D-CAM.Results Correlation analyses between each item and its total score showed that the correlation coefficients ranged between 0.290 and 0.724,all reaching statistical significance(P＜0.01).Inter-assessor reliability in a sample size of 30 patients resulted in a kappa value of 0.78 (P ＜ 0.001).Compared with the gold standard,the diagnostic and statistical manual of mental disorders(DSM-5)by American Psychiatric Association(APA),the sensitivity of the Chinese version of 3D-CAM was 94.73％,the specificity was 97.92％,the positive predictive value was 90.00％,and the negative predictive value was 98.95％.Conclusions The Chinese version of 3D-CAM has achieved satisfactory reliability and validity through pilot runs in surgery and internal medicine inpatients,proved to be easy and convenient to administer,and can be used as an assessment tool for delirium in elderly surgery and internal medicine patients.
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Objective To investigate the association of frailty with serum inflammatory biomarkers and geriatric parameters.Methods A total of 299 elderly people aged 60 and over were recruited,received frailty and comprehensive geriatric assessment,and were tested on serum levels of interleukin-10 (IL-10),interleukin-1β (IL-1β),monocyte chemoattractant protein-1 (MCP-1),monocyte chemoattractant protein-3 (MCP-3),macrophage inflammatory protein 1a (MIP-1α),macrophage inflammatory protein-1β (MIP-1β),tumor necrosis factor α (TNF-α),nuclear factor-κB (NF-κB) and sirtuin-1 (SIRT-1).Potential association of frailty with these biomarkers and several geriatric parameters was analyzed.Results Statistical differences in serum levels of MCP-1,MIP-1α and MIP-1β were detected between the frailty group and the non-frailty group (H=10.766,10.766 and 8.217,respectively;P =0.005,0.043 and 0.016,respectively).Logistic regression analyses showed that MCP-1 and MIP-1β were associated with frailty after adjustment for age,sex,body mass index (BMI),smoking,drinking,comorbidity and comprehensive geriatric assessment (OR=2.493,2.531,both F＜0.05).Conclusions MCP-1 and MIP-1β are risk factors for frailty.
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Older patients often experience a loss of physical,cognitive and social functioning during an acute illness-caused hospitalization.The loss of function could be due to a traditional model of hospital care,which focuses only on diagnosis and treatment of acute disease.Restoration of elderly patients' lost functions is important for better prognosis of hospitalized elderly patients and would reduce the cost of additional medical treatment.Acute care for the elderly (ACE) is a new model of care aiming at function restoration by practicing a geriatric assessment in the special ACE unit of hospital.The ACE intervention includes interdisciplinary team rounds,discharge planning of hospital,medical care review,a prepared environment,and patient-centered care.Multiple randomized control trials have demonstrated that ACE unit can improve the functional status and prognosis of old patients,reduce the cost of hospitalization,and improve patients' satisfaction.Currently,ACE care model is poorly known by Chinese hospitals and doctors.This article introduces the concepts of ACE unit,technical elements and the clinical evidence of its effectiveness.
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Objective To investigate influencing factors for comprehensive geriatric assessment carried out in geriatric departments of comprehensive hospitals in Sichuan province and its influential factors ,in order to verify whether education affects CGA and to raise medicine quality of senile disease. Methods The self-designed questionnaires were distributed to 40 hospitals in difference downs and cities in Sichuan province. The data were collected ,including items of CGA carried out in each hospital ,structure of staff ,scale ,bed distribution ,numbers of bed in geriatric department ,etc. The correlations of CGA items with the related factors were analyzed by using multiple linear regression analysis. Results The items of CGA carried out was positively related with hospital grade (β= -5.4 ,P=0.03) ,the staff-attending three times or more of geriatric training course (β=0.2 ,P=0.05) , the number of nurses per bed(β=15.6 ,P=0.03) ,the number of physicians with master's degree(β=-0.2 ,P=0.04) ,and the lower average age of medical staff (β= -0.6 ,P=0.05). Conclusions The grade of hospital ,attending actively geriatric training course ,the number of the nurses per bed ,the number of physicians with master's degree ,and the younger average age of medical staff were positively associated with the items of CGA carried out in hospitals.
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Frailty is an age-related non-specificity status caused by a decline of physiological reservation,which leads to an increase of vulnerability in body and decrease of ability in stress resistance.The pathophysiology of frailty involves multiple systems including neuromuscular system,metabolism and immune system.Studies have showed that frailty is closely related with negative events of elder people.People with frailty are subject to higher risks for fall,hospitalization,and mortality.However,the development of frailty can be delayed if early prevention or interventions are performed.Prospective cohort studies have showed that the risk factors for frailty include age,gender,family history of obesity,BMI,waist circumference,blood pressure,hyperglycemia,smoking and lack of exercise.Among them,nutrition,exercise and therapeutic drugs are hot spots in prevention study.Here,we reviewed the intervention studies by focusing on nutrition,exercise and therapeutic drugs in frail population.
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Frailty is a common state or syndrome with a decline in physiological reserves and an increase in an individual's vulnerability for stress in the elderly.Frailty can increase the risk of disability,falls,hospitalization,delirium and mortality.However,the intervention of frailty is under the scarcity and its effectiveness is not satisfied.We need to find new targets to treat frailty according to the pathophysiology of frailty.Human physiology is very similar to that of mouse,thus,mouse can be an ideal animal model of human disease.Mouse models can provide insight into pathogenesis of frailty by reducing the influence of genetic and environment factors and provide more basic data for further studies of frailty.At present,the research on a mouse model of frailty is still in its infancy and still needs further study.This review will summarize the related studies and propose some new ideas for future studies on mouse model of frailty.
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Disability is one of the common geriatric syndromes.Researches addressing elderly disability are still in starting stages.Both opportunities and challenges occur in this field.In this review,we summarized the definition and diagnostic criteria popular assessment tools for the diagnosis of elderly disability,the disease burden and relevant studies regarding elderly disability.
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Abdominal aortic aneurysms(AAAs) is the most common aneurysm,and usually characterized by less symptom.While ruptured AAAs leads to high mortality.Abdominal ultrasonography can effectively detect AAA,decrease the AAAs-related mortality.However,screening AAAs causes some adverse outcomes,including psychological distress and immediate harms in treatment.Meanwhile,the prevalence of AAAs in sex and age is significantly different.Therefore,a reasonable and effective screening strategy is very important.This article search random control trials,systematic reviews,meta-analysis and guidelines in screening AAAs to obtain a reasonable screening strategy.
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Cardiovascular disease is a severe threat to human health and life. Among many risk factors of cardiovascular disease, genetic or gene-based ones are drawing more and more attention in recent years. Accumulated evidence has demonstrated that the loss or mutation of ataxia telangiectasia mutated (ATM) gene can result in DNA damage repair dysfunctions, telomere shortening, decreased antioxidant capacity, insulin resistance, increased lipid levels, etc., and thus can promote the occurrence of cardiovascular risk factors, such as aging, atherosclerosis and metabolic syndrome. In this review, we discusses the possible mechanisms between ATM gene and cardiovascular risk factors, which could be helpful to the related research and clinical application.
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Humanos , Envelhecimento , Proteínas Mutadas de Ataxia Telangiectasia , Genética , Doenças Cardiovasculares , Genética , Dano ao DNA , Reparo do DNA , Mutação , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan's syndrome, and discuss some proposed potential mechanisms for this relationship.</p><p><b>DATA SOURCES</b>The data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013. The search term was "Marfan's syndrome and sleep apnea".</p><p><b>STUDY SELECTION</b>Clinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan's syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan's syndrome, and coexisting obstructive sleep apnea.</p><p><b>RESULTS</b>A high prevalence of obstructive sleep apnea exists in patients with Marfan's syndrome. The potential reasons are craniofacial abnormalities and lax upper airway muscles, which lead to high nasal airway resistance and upper airway collapse. Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms. The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan's syndrome.</p><p><b>CONCLUSIONS</b>Obstructive sleep apnea is strongly associated with Marfan's syndrome. Craniofacial abnormalities and lax upper airway are the main mechanisms. Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture. Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan's syndrome.</p>
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Humanos , Síndrome de Marfan , Epidemiologia , Prevalência , Apneia Obstrutiva do Sono , EpidemiologiaRESUMO
ObjectiveTo determine whether simvastatin alleviates lower urinary tract symptoms (LUTS) in patients with metabolic syndrome (MS) coexisting with benign prostate hyperplasia (BPH) and explore an optimized scheme of treatment. MethodsFrom February to June in 2011,30 male subjects with MS and LUTS caused by BPH in out-patients and in-patients from geriatric department were recruited.The patients were randomly assigned to receive orally simvastatin (40 mg) and tamsulosin (0.2 mg) quaque noete as combination treatment group or only tamsulosin (0.2 mg,quaque nocte) as single treatment group for 8 weeks.International prostate symptoms score (IPSS),quality of life (QOL),maximum flow rate (MFR) and prostate volume (PV),liver enzymes,creatinine and routine urine test were monitored to evaluate the effectiveness and safety before and after the treatment.Results In the two groups,the significant differences were found in the levels of IPSS,QOL and MFR,while there was no difference in PV between pre-treatment and post-treatment.The scores of IPSS after treatment were (6.4 ± 4.4) in combination treatment group and(4.2±3.3)in single treatment group (P＜0.05),and there were significant difference in scores of IPSS before and after the treatment between two groups (P＜0.05),suggesting better improvement in combination treatment group than in single treatment group.In two groups,there were no adverse events,and no changes were found in liver and kidney function,muscle enzymes and routine urine test.Conclusions Combined tamsulosin and simvastatin treatment may alleviate LUTS caused by BPH and are well tolerated with no adverse events.
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To determine whether lentinan could upregulate the expression of human-beta-defensin-2(HBD-2) in pulmonary epithelial cells (SPC-A-1), we stimulated pulmonary epithelial cells with lentinan and detected the expression of HBD-2mRNA by RT-PCR test. The results demonstrated that the expression of HBD-2mRNA in SPC-A-1 could be induced by lentinan in a concentration and time-dependent manner.
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Humanos , Adjuvantes Imunológicos , Farmacologia , Células Epiteliais , Metabolismo , Lentinano , Farmacologia , Pulmão , Biologia Celular , Metabolismo , RNA Mensageiro , Genética , Metabolismo , beta-Defensinas , Genética , MetabolismoRESUMO
Objective To investigate the relationship between lipid abnormality and benign prostatic hyperplasia (BPH) in men receiving physical examination. MethodsFour hundred and one people who participated health examination in our hospital in May 2008 were included in the study. They were divided into two groups according to history of disease, IPSS score, the results of digital rectal examination and transrectal ultrasound: BPH group (192 cases) and no BPH group (209 cases). The blood lipid level and risk factors were compared in two groups. ResultsThere were no statistical differences in blood lipid level and risk stratification of cardiovascular disease between the two groups (TG:P=0. 698;TC:P=0. 654;LDL-C:P=0. 880; HDL-C:P=0. 531; risk stratification: P= 0. 251). IPSS score had no obvious correlation with blood lipid level (TG: P = 0. 054 ; TC: P =0. 149; LDL-C: P = 0. 427; HDL-C:P=0. 193) .Conclusions BPH complicated with lipid abnormality is common in the clinics, but the correlation between BPH and lipid abnormality in patients with light BPH is not so clear as that in patients with mild or severe BPH.
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In this study, HBD-2 eukaryotic expression recombinant plasmid pcDNA 3.1-zeo(+)-HBD-2 was constructed by the molecular cloning technologies, and 293 cells were transfected by liposome. The cell culture supernatant was collected and its antibacterial activities against Staphylococcus aureus ATCC25923 and Pseudomonas aeruginosa ATCC27853 were tested. The antibacterial activity against S. aureus of the culture supernatant of the HBD-2 gene transfected-293 cells was detected, whereas in the same condition, the antibacterial activity against P. aeruginosa was not detected. This result suggested that HBD-2 may preferentially kill Staphylococcus aureus.
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Humanos , Anti-Infecciosos , Farmacologia , Linhagem Celular , Vetores Genéticos , Rim , Biologia Celular , Embriologia , Plasmídeos , Proteínas Recombinantes , Genética , Metabolismo , Farmacologia , Transfecção , beta-Defensinas , Genética , Metabolismo , FarmacologiaRESUMO
OBJECTIVE: To explore the effects of Houttuynia Cordata on expression of human beta-defensin-2 (HBD-2) in pulmonary epithelial cells (SPC-A-1) in vitro; and to observe the correlationship between the level of HBD-2 mRNA and the concentrations or treatment times of Houttuynia Cordata. METHODS: The SPC-A-1 cells were cultured with different concentrations of Houttuynia Cordata in vitro, including 0, 12.5, 25, 50, 100 and 200 microg/ml. And then, the SPC-A-1 cells were cultured with the optimal concentration of Houttuynia Cordata in different lengths of time, including 1, 2, 4, 8, 16 and 24 hours. After the treatment, the mRNA level of HBD-2 in pulmonary epithelial cells was detected by means of semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: After being cultured with Houttuynia Cordata, the expression of HBD-2 mRNA had positive correlation with the stimulus concentrations (rs=0.829, P=0.042) and stimulus time (rs=0.914, P=0.003). The highest expression of HBD-2 mRNA was induced by 100 microg/ml Houttuynia Cordata after 8-hour treatment. In comparison with the normal control group and the interleukin-1beta group, 100 microg/ml Houttuynia Cordata could significantly up-regulate the expression of HBD-2 mRNA in SPC-A-1 cells after 8-hour treatment (P<0.01). CONCLUSION: Houttuynia Cordata can up-regulate expression of HBD-2 mRNA in SPC-A-1 cells, and the highest expression level of HBD-2 mRNA can be obtained by culture with 100 microg/ml Houttuynia Cordata for 8 hours.
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Objective To explore the protective effect of atorvastatin(Lipitor) on the acute lung injury with ischemia-reperfusion and its possible mechanism.Methods Single lung in site ischemia-reperfusion animal model was used.Thirty Wistar rats were randomly divided into three equal groups and 10 rats were in each group:sham operate group(SO),pulmonary models of ischemia-reperfusion injury(IR) and atorvastation treated group(AT).The two latter groups were all ischemia for 60 minutes followed by reperfusion for 120 minutes.In the AT group,each rat was treated with atorvastation(10mg/kg) for the seventh day.Wet to dry weight rate(W/D),lung permeability index(LPI) were measured respectively.Lung tissue was observed by light microscope.Immunohistochemical technique was used to determine the immunoractivity of nityic oxide synthase(NOS).Results The levels of LPI and W/D were significantly decreased in AT group than in IR group by statistically significant differences(P