The relationship between mild cognition impairment and components of metabolic syndrome in the elderly / 中华老年医学杂志

Objective:To explore the relationship between mild cognition impairment(MCI) and components of metabolic syndrome in the elderly.Methods:A total of 293 patients aged 65 years and older with an average age of (78.8 ± 7.5) years who met the inclusion criteria were included.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate cognitive function.The components of the metabolic syndrome were compared between the MCI and the normal cognitive function(NC) groups.Binary Logistic regression analysis was used to analyze the relationship between cognitive function and components of the metabolic syndrome.Results:The levels of body mass index(BMI)and tryglicerides(TG)were lower in the MCI group than in the NC group[BMI, (22.9±3.7)kg/m 2vs.(25.3±3.3)kg/m 2, t=3.124, P=0.002; TG, 1.2±0.6 mmol/L vs. 1.4±0.7 mmol/L, t=2.615, P=0.009]. The differences in proportions of hypertension and diabetes and in levels of fasting blood glucose and high-density lipoprotein cholesterol had no statistically significance between the MCI group and the NC group(all P>0.05). Binary multivariate Logistic regression analysis showed that after adjusting for age and education, BMI was independently associated with MCI, and as BMI increased, the risk of MCI decreased( OR=0.901, 95% CI: 0.838-0.968, P=0.004). In elderly men, after adjusting for age, education level and smoking history, TG was independently associated with MCI, and as TG increased, the risk of MCI decreased( OR=0.446, 95% CI: 0.249-0.874, P=0.017). While in elderly women, no independent correlation between TG and MCI was observed. Conclusions:BMI is independently associated with MCI.Screening for cognitive function among low-level BMI elderly is helpful to identify MCI.The relationship between TG and MCI is different between different genders, and different standards might be adopted for the management of TG in elderly MCI patients with different genders.

Online control of chlorogenic acid in Lonicerae Japonicae Flos by near infrared spectroscopy combined with different variable selections / 中草药

Objective: To determine the content of chlorogenic acid in Lonicerae Japonicae Flos by the combined near-infrared and variable selection methods. Methods: Synergy interval partial least squares (SIPLS), competitive adaptive reweighted sampling method (CARS), variable importance in projection (VIP), and successive projections algorithm (SPA) were used to build a chlorogenic acid quantitative model in Lonicerae Japonicae Flos and compare. High performance liquid chromatography (HPLC) was used as a reference to select the optimum variable screening method. Results: Study results showed that SIPLS was the most desirable method for chlorogenic acid in regression performance with Rpre2 at 0.990 3 and RMSEP at 2.316%. Conclusion: The quantitative model of chlorogenic acid established by NIR combined with SIPLS has good performance and meets the requirement of real-time analysis of traditional Chinese medicine production process.

Transperitoneal versus extraperitoneal robot-assisted radical prostatectomy for localized prostate cancer / 中华男科学杂志

Objective@#To compare the clinical effects of transperitoneal (Tp) versus extraperitoneal (Ep) robot-assisted radical prostatectomy (RARP) in the treatment of localized prostate cancer.@*METHODS@#We searched PubMed, EMBASE, Web of Science, EBSCO, Cochrane Library, Wanfang, CNKI, and CBM for the articles comparing the clinical effect Tp-RARP with that of Ep-RARP in the treatment of localized prostate cancer published from January 2000 to November 2016. All the articles must meet the inclusion criteria, that is, dealing with at least one of the following aspects: operation time, intraoperative blood loss, postoperative catheterization time, length of bed confinement, perioperative complications, positive surgical margins, bowel-related complications, postoperative anastomotic leakage, and postoperative urinary continence. We subjected the data obtained to statistical analysis using the RevMan5.3 software.@*RESULTS@#Two randomized controlled trials and six case-control studies were included in this meta-analysis, involving 451 cases of Tp-RARP and 676 cases of Ep-RARP. Compared with Tp-RARP, Ep-RARP showed significantly shorter operation time (WMD = 21.39, 95% CI: 7.54－35.24, P = 0.002), shorter length of bed confinement (WMD = 0.85, 95% CI: 0.61－1.09, P <0.001), and lower rate of bowel-related complications (RR = 9.74, 95% CI: 3.26－29.07, P <0.001). However, no statistically significant differences were found between the two strategies in intraoperative blood loss (WMD = －8.12, 95% CI: －27.86－11.63, P = 0.42), postoperative catheterization time (WMD = 0.17, 95% CI: －0.55－0.21, P = 0.38), or the rates of perioperative complications (RR = 1.34, 95% CI: －0.97－1.87, P = 0.08), positive surgical margins (RR = 1.24, 95% CI: 0.95－1.61, P = 0.12), anastomotic leakage (RR = 0.98, 95% CI: 0.46－2.10, P = 0.95), urinary continence at 3 months (RR = 0.96, 95% CI: 0.91－1.00, P = 0.05) and urinary continence at 6 months (RR = 1.00, 95% CI: 0.97－1.02, P = 0.82).@*CONCLUSIONS@#Ep-RARP has the advantages of shorter operation time, shorter length of bed confinement and lower rate of bowel-related complications over Tp-RARP, and therefore may be a better option for the treatment of localized prostate cancer. However, more multi-centered randomized controlled clinical trials are needed for further evaluation of these two approaches.

Research on modeling method to analyze Lonicerae Japonicae Flos extraction process with online MEMS-NIR based on two types of error detection theory / 中国中药杂志

To establish a rapid quantitative analysis method for online monitoring of chlorogenic acid in aqueous solution of Lonicera Japonica Flos extraction by using micro-electromechanical near infrared spectroscopy (MEMS-NIR). High performance liquid chromatography(HPLC) was used as reference method．Kennard-Stone (K-S) algorithm was used to divide sample sets, and partial least square(PLS) regression was adopted to establish the multivariate analysis model between the HPLC analysis contents and NIR spectra. The synergy interval partial least squares (SiPLS) was used to selected modeling waveband to establish PLS models. RPD was used to evaluate the prediction performance of the models. MDLs was calculated based on two types of error detection theory, on-line analytical modeling approach of Lonicera Japonica Flos extraction process was expressed scientifically by MDL. The result shows that the model established by multiplicative scatter correction(MSC) was the best, with the root mean square with cross validation(RMSECV), root mean square error of correction(RMSEC) and root mean square error of prediction(RMSEP) of chlorogenic acid as 1.707, 1.489, 2.362, respectively, the determination coefficient of the calibration model was 0.998 5, and the determination coefficient of the prediction was 0.988 1．The value of RPD is 9.468.The MDL (0.042 15 g•L⁻¹) selected by SiPLS is less than the original,which demonstrated that SiPLS was beneficial to improve the prediction performance of the model. In this study, a more accurate expression of the prediction performance of the model from the two types of error detection theory, to further illustrate MEMS-NIR spectroscopy can be used for on-line monitoring of Lonicera Japonica Flos extraction process.

Effect of glutamine on intestinal mucosal barrier function in rats with acute hepatic injury / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the role of glutamine in LPS and D-Gal induced acute hepatic injury.</p><p><b>METHODS</b>A total of 61 Wistar rats were randomly divided into three groups: control group, model group and GLN pretreated group. The animal model was established by LPS and D-Gal intraperitoneal injection. GLN at dose of 1 g/kg was intragastrically administrated for 7 d before intraperitoneal injection. To evaluate the hepatic injury, the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) were detected by automatic biochemistry analysator. The liver and bowel tissue was observed by lightmicroscope and transmission electron microscope (TEM). The apoptosis of hepatocyte was detected by TUNEL. HPLC-PED was used in the study of intestinal permeability.</p><p><b>RESULTS</b>No significant differences were noted between ALT, AST, TBIL level, death rate and intestinal permeability (L/M) between model group and GLN pretreated group; In microscope, the confused structure of hepatic injury and inflammatory infiltration were similar between model group and GLN pretreated group. The injury of bowel was not obviously. Compared with the model group, there was better trend in liver and bowel in GLN pretreated group by transmission electron microscope (TEM). The apoptosis index in GLN pretreated group were lower than those in model group.</p><p><b>CONCLUSION</b>LPS can induce acute liver injury in D-Gal-sensitized rats.Glutamine has't the trend of protecting liver function and intestinal barrier function,decreasing death rates.</p>

Establishment of a D-galactosamine/lipopolysaccharide induced acute-on-chronic liver failure model in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To establish a practical and reproducible animal model of human acute-on-chronic liver failure for further study of the pathophysiological mechanism of acute-on-chronic liver failure and for drug screening and evaluation in its treatment.</p><p><b>METHODS</b>Immunological hepatic fibrosis was induced by human serum albumin in Wistar rats. In rats with early-stage cirrhosis (fibrosis stage IV), D-galactosamine and lipopolysaccharide were administered. Mortality and survival time were recorded in 20 rats. Ten rats were sacrificed at 4, 8, and 12 hours. Liver function tests and plasma cytokine levels were measured after D-galactosamine/lipopolysaccharide administration and liver pathology was studied. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay.</p><p><b>RESULTS</b>Most of the rats treated with human albumin developed cirrhosis and fibrosis, and 90% of them died from acute liver failure after administration of D-galactosamine/lipopolysaccharide, with a mean survival time of (16.1+/-3.7) hours. Liver histopathology showed massive or submassive necrosis of the regenerated nodules, while fibrosis septa were intact. Liver function tests were compatible with massive necrosis of hepatocytes. Plasma level of TNFalpha increased significantly, parallel with the degree of the hepatocytes apoptosis. Plasma IL-10 levels increased similarly as seen in patients with acute-on-chronic liver failure.</p><p><b>CONCLUSION</b>We established an animal model of acute-on-chronic liver failure by treating rats with human serum albumin and later with D-galactosamine and lipopolysaccharide. TNFalpha-mediated liver cell apoptoses plays a very important role in the pathogenesis of acute liver failure.</p>

A clinicopathological study on nonalcoholic steatohepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the pathological and clinical characters of nonalcoholic steatohepatitis (NASH).</p><p><b>METHODS</b>Liver biopsy tissues taken from 97 patients negative for common viral detection with serological test and immunohistochemistry as well as in situ hybridization, were observed by routine light microscopic examination. And the clinical data of patients with NASH was analyzed.</p><p><b>RESULTS</b>Among the chronic hepatitis patients with unknown etiology, the detection rate of NASH was 15.5% (15/97). The characteristic lesions in NASH patients included macrovesicular steatosis in zone 3 of lobules, hepatocytes ballooning degeneration, lobules diffused with acute and chronic inflammation, and perisinusoidal fibrosis. Grading and staging according to Brunt's method, histological lesions could be accounted for G1S1 in 7 patients, G2S2 in 3 patients, G3S1 in 4 patients and G3S2 in 1 patient. There were 14 patients with mild to moderate elevation of transaminase, 10 with hyperlipemia, 8 with diabetes and 9 with fatty liver by ultrasonography.</p><p><b>CONCLUSION</b>Nonalcoholic steatohepatitis is a common form of unknown etiology chronic liver disease with certain clinic-pathological features.</p>

Detection of hepatic progenitor cells in patients with severe hepatitis and their distribution / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To identify hepatic progenitor cells (HPCs) in patients with severe hepatitis (SH) by detecting their markers and investigate the features of their distribution and location.</p><p><b>METHODS</b>Liver tissues taken from 59 SH patients were tested for the receptor of stem cell factor (c-kit), pi-class glutathione S-transferase (GST-pi), cluster of differentiation 34 (CD34), cytokeratin 19 (CK19), cytokeratin 18 (CK18) and alpha fetoprotein (AFP) by immunohistochemistry (IHC). Meanwhile, 58 patients with acute or chronic hepatitis were also detected to act as controls.</p><p><b>RESULTS</b>Hepatic progenitor cells could be seen in SH patients. Most of them existed as ductular cells that had been called "typical ductular proliferation (ADP)" or "typical ductular reaction" in previous research. These ductular cells were mainly located at the portal areas, fibro septa, periportal parenchyma and the border of the pseudolobuli and inflammatory foci. Further, c-kit, GST-pi, CK19 and CK18, but not CD34 and AFP could be detected in these cells. Another kind of HPC was the small hepatocyte-like cell (SHLC), which could express c-kit, GST-pi, and CK18, but not CK19, CD34 and AFP. The semi-quantitative analysis showed that the scope of ADP in SH patients was significantly larger than that in acute and chronic hepatitis patients (chi2= 63.62, P<0.05), and the scope of ADP in subacute severe hepatitis and chronic severe hepatitis patients was also significantly larger than that in acute severe hepatitis patients.</p><p><b>CONCLUSION</b>In the course of regeneration of viral hepatitis, different types of pathology have different features. In acute and chronic hepatitis (G1-2), the regeneration is mainly owing to the proliferation of mature hepatocytes, and in chronic hepatitis (G3-4), there is the participation of HPCs, although they are limited. In severe hepatitis, however, since the replicative capacity of normal hepatocytes is impaired or prohibited, liver regenerates and restores mainly by the means of hepatic stem cells activation and proliferation. But the hepatic stem cells don't differentiate into their mature functional compartments directly at all. There are several intermediary or transition populations. In human severe hepatitis, they are mainly ductular cells, and parts of them are small hepatocyte-like cells.</p>

A clinicopathological study on 3 cases of severe acute respiratory syndrome / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation.</p><p><b>METHODS</b>Tissue specimens from 3 autopsy cases of diagnosed SARS were studied under microscopy and the clinical data were reviewed.</p><p><b>RESULTS</b>The typical pathological changes of lungs were diffuse hemorrhage on surface. A mixture features of serous, fibrinous and hemorrhagic inflammation were seen in most pulmonary alveoli with engorgement of capillary and there were microthrombosis in some capillary. Pulmonary alveoli became thick with interstitial mononuclear inflammatory infiltration, diffused alveoli damage, desquamation of pneumocytes and hyaline-membrane formation. Fibrinoid materials and erythrocytes could be found in alveolar spaces. There were thrombo-embolisms in some bronchial artery. Meanwhile, haemorrhagic necrosis was showed in lymph nodes and spleen with attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and some lesions observed in liver, heart, kidney, pancreas may have existed before the hospitalization.</p><p><b>CONCLUSION</b>Severe damages of pulmonary and immunological system damage are responsible for clinical features of SARS and may lead to death of patients.</p>