[The application of 3D bioprinting in ophthalmology].

On the basis of 3D printing technology, 3D bioprinting has emerged with great development potential and good prospects in the field of medicine and tissue engineering. With this technique, different types of cells and biomaterials can be precisely incorporated into 3D anatomical structures, achieving tissue substitutes with superior structures or functions. In recent years, great progress has been made in the application of 3D bioprinting in ophthalmology. This article reviews not only the differences between 3D printing and 3D bioprinting, but also the development, types, characteristics, application, and prospects of 3D bioprinting in the production of eye tissue engineering materials.

MiR-421 expression independently predicts unfavorable overall survival in patients with esophageal adenocarcinoma.

OBJECTIVE: This study aimed to examine the prognostic value of miR-421 in terms of overall survival (OS) and recurrence free survival (RFS) in ESAD and its potential regulatory network. PATIENTS AND METHODS: An in-silico analysis was conducted using data from large databases, including The Cancer Genome Atlas-Esophageal Carcinoma (TCGA-ESCA), Starbase 3.0 and GeneMANIA. RESULTS: Both esophageal adenocarcinoma (ESAD) and esophageal squamous cell carcinoma (ESCC) tissues had significantly upregulate miR-421 expression, compared with adjacent normal tissues. Upregulated miR-421 expression was associated with shorter OS, but not RFS in ESAD. In patients with ESCC, no difference in miR-421 expression was observed regards to OS or RFS status. Univariate and multivariate analysis showed that high miR-421 expression was independently associated with shorter OS (HR: 2.77, 95%CI: 1.41-5.46, p<0.01), after adjustment of histological grade and pathological stages. The predicted regulatory network of miR-421 in ESAD includes both tumor suppressors and oncogenes, which makes the role of miR-421 quite mysterious in this cancer. CONCLUSIONS: MiR-421 expression might serve as a valuable prognostic biomarker in patients with ESAD. But future molecular studies are required to explore the exact regulatory effect of it.

Associations between Sarcopenic Obesity and Cognitive Impairment in Elderly Chinese Community-Dwelling Individuals.

INTRODUCTION: This study aimed to estimate the prevalence of sarcopenic obesity (SO) and the association between cognitive impairment and SO in a cohort of elderly Chinese community-dwelling individuals. METHODS: A total of 948 elderly Chinese community-dwelling individuals aged 60-92 years were recruited. The participants were categorized into the following four groups according to their sarcopenia and obesity status: sarcopenic obese, sarcopenic, obese and non-sarcopenic, and non-obese group. Sarcopenia was defined as appendicular skeletal muscle index of <7.0 kg/m2 in men and <5.7 kg/m2 in women; obesity was defined as values greater than the upper two quintiles for body fat percentage stratified by gender of the study population; cognitive impairment was measured using the Mini-Mental State Examination and defined as a score of <24. RESULTS: A total of 945 participants were included in the statistical analyses with a mean age of 68.76 ± 6.50 years. The prevalence of SO was 6.0% (7.3% in men and 4.8% in women). The sarcopenic obese (odds ratio [OR]: 2.550, 95% confidence interval [CI], 1.196-5.435) and obese (ORs: 2.141, 95% CI, 1.230-3.728) groups had significantly increased risk for cognitive impairment in fully adjusted model, respectively. CONCLUSION: The SO prevalence in elderly Chinese community-dwelling individuals was relatively low (6.0%). The present study suggested SO was independently associated with cognitive impairment.

G-395A polymorphism in the promoter region of the KLOTHO gene and hypertension among elderly (90 years and older) Chinese individuals.

The aim of this study was to examine the possible associations between the KLOTHO G-395A gene polymorphism and hypertension in Chinese nonagenarians and centenarians. The G-395A (rs1207568) in the promoter region of the KLOTHO gene was genotyped using a standard TaqMan allelic discrimination assay. We included 710 participants aged 93.5 ± 3.2 years in the analyses. The expression of the A allele of the KLOTHO G-395A polymorphism was significantly downregulated in the hypertension group compared to the control group (0.137 vs 0.200, P < 0.001). The genotype distribution of the G-395A polymorphism between the hypertension and control groups was significantly different in women and smokers, and not in men or non-smokers. The mean systolic blood pressure, percentage of hypertension, and percentage of isolated systolic hypertension was significantly higher in the group with the GG genotype than in the group with the GA+AA genotype. Subjects expressing the GA+AA genotype demonstrated a significantly lower risk of hypertension even after adjusting for age, gender, and other relevant risk factors compared to the population expressing the GG genotype (odds ratio, 0.68; 95% confidence interval: 0.49 to 0.95).The -395A allele of the KLOTHO gene may be a protective genetic factor for hypertension in the Chinese population.

Association between the rs189037 single nucleotide polymorphism in the ATM gene promoter and cognitive impairment.

The aim of this study was to explore the existence of a relationship between the rs189037 single nucleotide polymorphism (SNP) of the ataxia telangiectasia mutated (ATM) gene and cognitive impairment in the elderly (aged 60 years and above). In a cohort, 505 residents of Suinung City were consecutively recruited and their cognitive function was measured using a 30-point Mini-Mental State Examination (MMSE). The subjects were divided into cognitive impairment group and control group on the basis of MMSE scores. Presence of the rs189037 SNP variant was examined using polymerase chain reaction-restriction fragment length polymorphism. The prevalence rates of cognitive impairment were 32.7% in the whole sample. The genotype frequencies of the rs189037 polymorphism were 33.5% (CC), 50.7% (CT), and 15.8% (TT); the C and T allele frequencies were 58.8 and 41.2%, respectively. No significant differences in the frequency distributions of the CC, CT and TT genotypes were observed between cognitively impaired and control groups. We found that the rs189037 SNP was not directly correlated with cognitive impairment among the elderly Chinese Han population.

A survey of physicians who care for older persons in Southwest China.

OBJECTIVE: The aim of this survey is to determine the main barriers of geriatric health care from the physicians' point of view and compare the improvement before and after the Continue Medical Education (CME) provided by International Association of Gerontology and Geriatrics (IAGG). DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: Five hundred samples were generated using systematic random sampling from the address lists of physicians in Southwest China who had received the IAGG CME or been trained in Sichuan Association of Geriatrics (SAG) CME. MEASUREMENTS: The interview instrument examined demographics and information on geriatric education. RESULTS: Of the 500 physician sampled, 461(92.2 percent) responded. 34.3 percent of the respondents reported that over 70 percent of their patients were older persons. 76.8 percent of the respondents felt that they lacked geriatric knowledge. Only 15.6 percent of the respondents had geriatric curriculum before graduation, and 26.0 percent received geriatric trainings after graduation. Most physicians felt that "Language barrier" and "Insufficient geriatric education in undergraduate medical school and postgraduate education" were the main challenges in practicing geriatric medicine. Geriatric training and knowledge are inadequate due to the lack of geriatric curriculums in medical schools and CME for physicians who practice geriatrics. With the help of IAGG, CME in Southwest China provided more workshops on geriatric progress in year 2011 than in year 2007-2010. Eighty percent of the physicians acknowledged that the IAGG CME was helpful for their clinical practice. The physicians paid more attention to geriatric syndromes rather than age-related pathophysiology alone. CONCLUSION: CME provided by geriatric associations is helpful. Collaboration between different geriatric societies such as IAGG and SAG may be a good model for spreading geriatric knowledge and should be considered by medical educational administration.

Huperzine A for Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) has become a major public health problem around the world due to its increasing prevalence, long duration, caregiver burden, and high financial cost of care. The degeneration of acetylcholine-containing neurons in the basal forebrain has been implicated in the symptoms of AD. Cholinesterase inhibitors may block the degradation of acetylcholine, thus increasing the efficacy of the remaining cholinergic neurons. Huperzine A is a linearly competitive, reversible inhibitor of acetyl cholinesterase that is said to have both central and peripheral activity with the ability to protect cells against hydrogen peroxide, beta-amyloid protein (or peptide), glutamate, ischemia and staurosporine-induced cytotoxicity and apoptosis. These properties might qualify Huperzine A as a promising agent for treating dementia (including AD). OBJECTIVES: To assess the efficacy and safety of Huperzine A for the treatment of patients with AD. SEARCH STRATEGY: The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group was searched on 1 February 2006 using the search term: huperzin*. The CDCIG Specialized register contains records from all major health care databases (MEDLINE, EMBASE, PsycINFO, CINAHL, SIGLE, ISTP, INSIDE, LILACS) as well as from many trials databases and grey literature sources. In addition, the CBM and AMED databases and relevant websites were searched and some journals were hand-searched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references. SELECTION CRITERIA: All relevant randomized controlled trials (RCTs) studying the efficacy and safety of Huperzine A for AD. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers using a self-developed data extraction form and entered into RevMan 4.2.10 software. Meta-analyses were performed when more than one trial provided data on a comparable outcome on sufficiently similar patients. Random effects analyses were performed whenever heterogeneity between results appeared to be present. Standardized differences in mean outcome measures were used due to the use of different scales and periods of treatment. MAIN RESULTS: Six trials including a total of 454 patients met our inclusion criteria. The methodological quality of most included trials was not high. It was shown that compared to placebo, Huperzine A had beneficial effects on the improvement of general cognitive function measured by MMSE (WMD 2.81; 95% CI 1.87 to 3.76; P < 0.00001) and ADAS-Cog at six weeks (WMD 1.91; 95% CI 1.27 to 2.55) and at 12 weeks (WMD 2.51; 95% CI 1.74 to 3.28), global clinical assessment measured by CDR (WMD -0.80; 95% CI -0.95 to -0.65) and CIBIC-plus (OR 4.32, 95% CI 2.37 to 7.90), behavioral disturbance measured by ADAS-non-Cog at six weeks (WMD -1.33, 95%CI -2.12 to -0.54) and at 12 weeks (WMD -1.52, 95% CI-2.39 to -0.65), and functional performance measured by ADL (WMD = -7.17; 95% CI -9.13 to -5.22; P < 0.00001). However, Huperzine A was not superior to placebo in the improvement of general cognitive function measured by Hasegawa Dementia Scale (HDS) (WMD: 2.78; 95% CI -0.17 to 5.73, P = 0.06) and specific cognitive function measured by Weshler Memory Scale (WMS) (WMD = 6.64; 95% CI -3.22 to 16.50; P = 0.19). No data were available on quality of life and caregiver burden. The adverse events of Huperzine A were mild and there were no significant differences of adverse events between Huperzine A groups and control groups. AUTHORS' CONCLUSIONS: From the available evidence, Huperzine A seems to have some beneficial effects on improvement of general cognitive function, global clinical status, behavioral disturbance and functional performance, with no obvious serious adverse events for patients with AD. However, only one study was of adequate quality and size. There is therefore inadequate evidence to make any recommendation about its use. Rigorous design, randomized, multi-centre, large-sample trials of Huperzine A for AD are needed to further assess the effects.

[Clinical significance of fibronectin and protease inhibitors in chronic obstructive pulmonary diseases].

Plasma fibronectin (Fn) and protease inhibitors (alpha 2-macroglobulin, alpha 2-MG, antithrombin, AT-III activity and content) were measured in 74 COPD patients and 53 normal controls. It was showed: (1) Fn, alpha 2-MG. AT-III activity were considerably decreased in COPD, when compare with that of controls; (2) there is a negative correlation between the value of PaCO2, r = -0.719, P less than 0.01. It indicated that the Fn, AT-III activity and alpha 2-MG are closely correlated with the extent and degree of respiratory decompensation. Dynamic changes of these parameters are of some prognostic significance in COPD.