Analysis on the development and influencing factors of frailty in elderly patients on maintenance hemodialysis / 中华老年医学杂志

Objective:To investigate the development and influencing factors of frailty in elderly patients on maintenance hemodialysis.Methods:A cross-sectional survey involved 146 elderly patients on maintenance hemodialysis at the blood purification department of the First Affiliated Hospital of Xi'an Jiaotong University.A self-designed demographic questionnaire was used to collect general information of patients, the Simple Physical Performance Scale(SPPB)was used to assess physical function, the 5-item SARC-F was used as a tool for rapid screening of sarcopenia, and the Hospital Anxiety and Depression Scale(HADS)was used for screening of anxiety and depression.The FRAIL scale was used for frailty assessment and participants were divided into a no frailty group, a pre-frailty group and a frailty group according to different frailty scores.Relevant influencing factors of frailty were analyzed.Results:Among 146 hemodialysis patients, 33(22.6%)were in the non-frailty group, 86(58.9%)in the pre-frailty group, and 27(18.5%)in the frailty group.Univariate analysis showed that there were statistically significant differences in sex( χ2=6.220, P=0.045), age( F=5.197, P=0.007), body type( χ2=31.927, P<0.001), SARC-F score( χ2=24.283, P<0.001)and SPPB score( χ2=26.773, P<0.001)between different groups.There were 3 patients(9.4%)at high risk for sarcopenia in the no frailty group, 13 patients(40.6%)at high risk for sarcopenia in the pre-frailty group, and 16 patients(50%)at high risk for sarcopenia in the frailty group, and differences in the occurrence of sarcopenia between the different subgroups of frailty were statistically significant( χ2=27.496, P<0.001). Multifactorial Logistic regression analysis showed that age, ( OR=1.04, 95% CI: 0.99-1.08, P=0.049), sex( OR=0.39, 95% CI: 0.17-0.87, P=0.021), body size( OR=0.07, 95% CI: 0.01-0.50, P=0.008), SARC-F( OR=0.14, 95% CI: 0.05-0.38, P<0.001)were independent influencing factors of frailty in elderly maintenance hemodialysis patients( P<0.05). Conclusions:The incidence of frailty is high in elderly patients on maintenance hemodialysis, and the development of frailty is affected by age, body mass index and sarcopenia.

Efficacy and safety observation of recombinant human interleukin-11 in treatment of thrombocytopenia induced by chemoradiotherapy / 国际肿瘤学杂志

Objective To observe the efficacy and safety of recombinant human interleukin-11 (rnIL-11) in the treatment of thrombocytopenia induced by chemoradiotherapy in patients with solid tumor.Methods Solid tumor patients whose PLT count was lower than 50 × 109/L from December 2010 to December 2012 in PLA general hospital of Chengdu Commond were studied.They were divided into two groups randomly.The observed group was given subcutaneous injection of recombinant human interleukin-11 (Ⅰ) at the dose of 25 g · kg-1 · d-1,until the PLT rising subsolute value was more than 50 × 109/L.The control group was given usual treatment.The vital signs,hepatorenal function,coagulation function and cardio-pulmonary function of the patients were recorded during the whole process of treatment.Results The patients after chemotherapy had the platelet lowest average of (27.4 ± 7.6) × 109/L,and the average of the control group was (28.1 ± 7.9) × 109/L.The difference was not statistically significant (t =1.083,P ＞ 0.05),but treatment after the observation of elevated had the platelet highest average of (116.3 ± 22.8) × 109/L,which was significantly higher than that of (76.2 ± 21.3) × 109/L; the difference was significant (t =21.092,P ＜ 0.05).Platelets of patients in the observation group were ＜50 × 109/L for several days with an average of (4.3 ± 1.7) d,while platelets rose from the lowest value of the average absolute value greater than 50 000 hours (6.8 ± 2.4) d,shorter than the control group.By comparing the two groups,the differences were significant (t =11.347,P ＜ 0.05 ; t =15.196,P ＜ 0.05).Two groups of patients can tolerate adverse reactions.Ⅲ,Ⅳ degree of adverse reaction was not observed.Conclusion This study shows that rhIL-11 is well tolerated and has thrombopoietic activity in the treatment of thrombocytopenia.

Human umbilical cord-derived mesenchymal stem cells co-cultured with hepatocytes can differentiate into hepatocyte-like cells / 中国组织工程研究

BACKGROUND:The studies have shown that the mesenchymal stem cel s derived from bone marrow and umbilical cord can be continuously cultured in vitro, and maintain the characteristics of stem cel s. The mesenchymal stem cel s can differentiate into hepatocyte-like cel s after“cocktail”induction by various cytokines. OBJECTIVE:To further identify whether umbilical cord-derived mesenchymal stem cel s in vitro co-cultured with normal hepatocytes can differentiate into hepatocyte-like cel s, and to investigate the differentiation method. METHODS:Mesenchymal stem cel s were isolated from human umbilical cord with adherent method, and the surface markers of umbilical cord-derived mesenchymal stem cel s were detected with flow cytometry. The umbilical cord-derived mesenchymal stem cel s were co-cultured with liver LO2 cel s without adding exogenous inducers. The expressions of alpha-fetoprotein, albumin and human cytokeratin 19 mRNA of hepatocyte specific markers were detected with reverse transcription PCR at 7, 14 and 21 days after culture, and periodic acid-Schiff staining was used to identify the functions. RESULTS AND CONCLUSION:Mesenchymal stem cel s could isolated from human umbilical cord successful y, showing fibroblastic morphology and adherent cel characterization. Among these cel s, 96.02%cel s were CD29 positive cel s and 96.6%cel s were CD105 positive cel s. The percentage of CD34 negative cel s was 99.65%. The percentage of CD105+CD29+double positive cel s was 94.84%. The mRNA of alpha-fetoprotein was found on the 7th day after co-cultured with LO2 cel s, and the mRNA of albumin and human cytokeratin 19 were found on the 14th day. After co-cultured for 21 days, the alpha-fetoprotein mRNA could not be observed in the co-culture group. The expressions of albumin and human cytokeratin 19 were increased at 14 days. After co-cultured for 21 days, the glycogen staining was positive. Umbilical cord-derived mesenchymal stem cel s can differentiate into hepatocyte-like cel s after co-cultured with normal hepatocytes.

Analysis of the P53 transcriptional activity in gastric cancer / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the transcriptional activity of P53 in gastric cancer.</p><p><b>METHODS</b>The activity of p53 in gastric cancer was investigated by dual-luciferase reporter assay. The coding sequence of the p53 was amplified by reverse transcription-polymerase chain reaction (RT-PCR) and sequenced. The expression of P21WAF1/Cip1, Gadd45alpha and Mdm2 was detected by immunohistochemistry in 76 samples of gastric carcinoma, and their adjacent tissues were analyzed as control.</p><p><b>RESULTS</b>The p53 activity was higher in human normal cell lines than that of gastric cancer. Furthermore, the transcriptional activity of P53 was lowest in MKN28 cells in which p53 was mutated. The expression level of P21WAF1/Cip1, Gadd45alpha and Mdm2 in the adjacent tissues was higher than that of cancer tissues (P<0.05), and there was a tendency of decline in the positive ratio with the poor differentiation of the carcinoma (P<0.05). In addition, a strong linear correlation was observed between P21WAF1/Cip1, Gadd45alpha and Mdm2 (P<0.05).</p><p><b>CONCLUSION</b>Changes of P53 transcriptional activity play an important role in the development of gastric cancer. p53 mutation could affect its transcriptional activity. P21WAF1/Cip1, Gadd45alpha and Mdm2 are a group of effecters that could reflect P53 transcriptional activity when detected together in cancer tissues.</p>

Survey of the three specialist medical practices including neurosurgery in Shanghai / 中华医院管理杂志

Objective To probe into the medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai, discovering measures and suggestions for improvement Methods Such methods as onsite inspection and questionnaires were called into play to study the practice of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in 68 secondary and tertiary hospitals. Results Such three disciplines in the 68 hospitals have in total 3288 beds, 1142 medical practitioners, 19 assistant medical practitioners, and 1983 nurses. In 10 of the 68 hospitals, the medical space for these disciplines is non-standard; In 3 hospitals, personnel use is non-standard in general; 8% of the medical records are incompliant in generals 15% of the prescriptions are incompliant in general. Conclusion Medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai is found to be legally compliant in general. However, there exist defects in medical space, personnel use, as well as medical records and prescriptions. In this regard, enhanced management and inspection are recommended.